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Ann Thorac Surg 1992;54:800-807
© 1992 The Society of Thoracic Surgeons

Articles

Video-assisted thoracic surgery: Basic technical concepts and intercostal approach strategies

Rodney J. Landreneau, MD*,a,b,c, Michael J. Mack, MDa,b,c, Stephen R. Hazelrigg, MDa,b,c, Robert D. Dowling, MDa,b,c, Tea E. Acuff, MDa,b,c, Mitchell J. Magee, MDa,b,c, Peter F. Ferson, MDa,b,c

a Section of Thoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
b Division of Cardiothoracic Surgery, Humana Hospital, Dallas, Texas, USA
c Division of Cardiothoracic Surgery, St. Luke's Medical Center, Milwaukee, Wisconsin, USA

* Address reprint requests to Dr Landreneau, Section of Thoracic Surgery, University of Pittsburgh, Montefiore University Hospital, 3459 Fifth Ave, Pittsburgh, PA 15213.

Video-assisted thoracic surgery is emerging as a viable approach to a number of intrathoracic disorders. Technical difficulties related to improper instrument selection and suboptimal intercostal operative access can reduce the utility of, and the enthusiasm for, the video-assisted thoracic surgical approach. This report describes the intercostal access strategy and the instrument positioning that we now prescribe for many video-assisted thoracic surgical procedures. These approaches have become refined during the course of our experience with 467 patients undergoing video-assisted thoracic operations over the last 18 months.




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