Chest tube entrapment: a simple solution for technical error.

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Medical Device Complications

Background:

• Chest tube insertion is common after cardiac surgery, like coronary artery bypass grafting (CABG).
• Entrapment of the chest tube by surgical closure is a rare but recognized technical complication.
• Prompt diagnosis and management are crucial to prevent patient morbidity.

Observation:

• A case of unrecognized chest tube entrapment occurred in an elderly male patient following CABG.
• The entrapment involved the chest tube being caught by surgical sutures during wound closure.
• This complication was identified post-operatively, necessitating intervention.

Findings:

• A novel, minimally invasive technique was employed for chest tube removal.
• A small endoscope was inserted through the chest tube to visualize the entrapping suture.
• Thoracoscopic scissors were used via the endoscope to carefully incise the suture material.
• Successful retrieval of the chest tube was achieved without requiring re-operation or extensive surgical exploration.

Implications:

• This endoscopic approach offers a safe, simple, and effective alternative for managing chest tube entrapment.
• It avoids the risks associated with surgical re-exploration, particularly in elderly or frail patients.
• The technique highlights the utility of endoscopy in resolving intra-thoracic device-related complications.