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Updated: Jul 26, 2025

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
An impressive case of isolated thoracic impalement
Gabriel Hunduma1, Maria Elena Vilar Alvarez1, Roy Kukreja2
1Wessex Cardiothoracic Department, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.
Case:
A 61-year-old male construction worker was admitted to our Emergency Department due to being impaled in the chest after fall onto the long pole of his cement mixer. He was promptly scanned through the CT then transferred to theatre where unique technique for intubation was utilised prior to performing a Video Assisted Thoracoscopic Surgery exploration and extraction of the foreign object.
Discussion:
Impalement injuries are classified into Types I or II depending on the direction of movement of the human body in relation to the foreign object. There currently is no consensus on the best management of chest wall injuries involving impalements. Our case utilised Video Assisted Thoracoscopic Surgery as the dominant method of intervention together with highly skilled anaesthetic preparation.
Conclusion:
The combined expert anaesthetic and surgical approach utilised collectively had a role in ensuring the best possible outcome for the patient.
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