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[Thoracoscopic lung biopsy (author's transl)]

K Wetzer, W Schilling, D Wenzel

    Zeitschrift Fur Erkrankungen Der Atmungsorgane
    |January 1, 1980
    PubMed
    Summary

    This study introduces a safer method for thoracoscopic lung biopsy using unilateral ventilation and a novel suction punch instrument, significantly reducing air embolism risks. The technique achieved an 89% diagnostic yield with no serious complications in 63 patients.

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    Area of Science:

    • Thoracic Surgery
    • Pulmonary Medicine
    • Medical Instrumentation

    Context:

    • Declining attitudes towards thoracoscopic lung biopsy due to risks like air embolism.
    • Lack of optimal instrumentation for minimally invasive lung biopsy procedures.
    • Previous methods did not adequately prevent intrathoracic pressure changes leading to complications.

    Purpose:

    • To investigate conditions leading to air embolism during thoracoscopic lung biopsy.
    • To develop and evaluate a novel instrument and technique for safer lung biopsies.
    • To improve the diagnostic yield and safety profile of thoracoscopic lung biopsy.

    Summary:

    • Air embolism is prevented by ventilating the non-biopsied lung unilaterally via a Carlens' double-lumen catheter.
    • The biopsied lung and pleural space are vented to the atmosphere through the catheter and thoracoscope.
    • A new 'suction punch' instrument, designed for precise tissue acquisition, was developed and utilized.
    • Sixty-three patients underwent thoracoscopic lung biopsy under general anesthesia with side-separated ventilation.
    • The procedure resulted in an 89% histologically verified diagnostic yield with no serious complications.

    Impact:

    • Establishes a safer, effective technique for thoracoscopic lung biopsy, potentially reversing declining attitudes.
    • The developed suction punch instrument offers improved tissue handling and diagnostic accuracy.
    • Provides a reliable method for obtaining lung tissue samples with minimal patient risk.

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