Single-Incision Thoracoscopic Surgery using Spinal Needle Anchoring.

Area of Science:

• Thoracic Surgery
• Minimally Invasive Procedures
• Pulmonary Medicine

Background:

• Single-incision thoracoscopic surgery (SITS) is preferred for primary spontaneous pneumothorax due to its advantages.
• A key challenge in SITS is achieving adequate lung retraction and stable lesion positioning.
• Existing methods may lead to instrument crowding and increased postoperative discomfort.

Purpose of the Study:

• To introduce and evaluate a modified SITS technique using spinal needle anchoring for improved lung stabilization.
• To assess the feasibility and benefits of this novel approach in managing primary spontaneous pneumothorax.
• To compare the outcomes of this modified SITS with conventional multiport techniques.

Main Methods:

• A modified SITS technique was developed utilizing a bent spinal needle inserted through an intercostal space.
• The spinal needle acted as a surrogate grasper, enabling precise lung stabilization and lesion manipulation.
• The technique allowed for multiple re-hooking maneuvers for optimal lesion alignment within a single incision.

Main Results:

• The spinal needle anchoring technique facilitated precise lung stabilization and effective lesion retraction.
• This method allowed for a smaller incision, reduced instrument crowding, and minimized postoperative pain.
• The needle insertion site resulted in no visible scarring, enhancing cosmetic outcomes.
• The technique proved beneficial for complex cases, including multiple bullae or challenging lung anatomy.

Conclusions:

• Spinal needle anchoring is a simple, effective modification to the SITS technique for primary spontaneous pneumothorax.
• This approach enhances surgical precision, improves patient comfort, and offers cosmetic advantages.
• The technique holds promise for broader application in SITS procedures requiring delicate lung manipulation.