Two-Site Thoracoscopic Surgery for Extra-Pulmonary Sequestration Using an Extraction Wound: Five Pediatric Cases With...

Area of Science:

• Pediatric Surgery
• Thoracic Surgery
• Minimally Invasive Surgery

Background:

• Thoracoscopic surgery is preferred for pediatric extrapulmonary sequestration (EPS) due to cosmetic advantages over open procedures.
• A limitation of current thoracoscopic approaches is the potential need for extended or additional incisions for specimen extraction.
• This can compromise the cosmetic benefits and procedural simplicity.

Observation:

• This report details a novel two-site thoracoscopic surgery (TTS) technique for left-sided EPS in 5 pediatric cases.
• The technique utilizes a single incision for both camera and instrument ports, facilitating specimen extraction without extension.
• Optical methods guided port placement within the existing incision.

Findings:

• The described TTS approach successfully resected and extracted EPS through a single skin incision in all 5 cases.
• No extension or additional incisions were required, preserving the cosmetic advantages of thoracoscopic surgery.
• The procedure was performed by a surgeon-in-training in 4 out of 5 cases, indicating its feasibility and teachability.
• All patients experienced uneventful postoperative courses with rapid recovery and excellent cosmetic results.

Implications:

• Two-site thoracoscopic surgery (TTS) presents a cosmetically superior and efficient alternative for managing pediatric extrapulmonary sequestration.
• This technique enhances the benefits of minimally invasive surgery by eliminating the need for specimen extraction incisions.
• Further adoption of TTS could improve patient satisfaction and surgical outcomes in pediatric thoracic procedures.