Laparoscopic pericardiotomy, biopsy, and external drainage

Laparoscopic pericardiotomy, biopsy, and external drainage can be performed effectively in a safe and efficient manner for benign and malignant pericardial effusions. This technique, although minimally morbid, allows for pericardiotomy with biopsy and placement of large drains under visual control. In this article, we describe the surgical technique, including external drain placement. We discuss our experience with laparoscopic drainage of an infected benign effusion with tamponade in a patient with chronic renal failure. A diagnostic laparoscopic pericardiotomy in a patient with penetrating lower thoracic trauma is also described. Potential advantages and disadvantages of the laparoscopic approach are discussed.