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Ann Thorac Surg 1993;56:620-623
© 1993 The Society of Thoracic Surgeons

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Articles

Equipment for thoracoscopy

Section of General Thoracic Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota USA

^_* Address reprint requests to Dr Allen, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.

The combining of miniaturized video technology with thoracoscopy now allows surgeons to perform a variety of thoracic procedures percutaneously. Both rigid and flexible video thoracoscopes are available. The rigid endoscope has a camera located proximally at the eyepiece and is capable of excellent resolution. However, visualization of the entire pleural cavity is difficult because of the rigid chest wall. Placing the video camera at the distal end of a flexible thoracoscope, as in the electronic video thoracoscope (EVE-L; Fujinon, Wayne, NJ), yields better visualization of these relatively inaccessible areas. However, disadvantages of the flexible thoracoscope include increased expense and complexity, reduced resolution as compared to rigid systems, and the need for a strobed light source, thus making videoassisted surgery more difficult. Thoracoscopic wedge excisions of the lung are now possible because of the adaptation of gastrointestinal staplers for percutaneous use. The initial design consisted of a reloadable 30-mm disposable stapler. Newer models, however, have a longer staple line and some are reusable. Future refinements may allow the head of the instrument to articulate, thus permitting it to be applied to the lung at various angles. Thoracoscopic ports that provide an air-tight seal are available but are not essential; therefore, standard thoracotomy instruments can be utilized through small open incisions. Specialized disposable thoracoscopic instruments are also available, including scissors, dissectors, and fan retractors. It is hoped that the future will bring improved optics, better staplers, and refined percutaneous instrumentation.

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				M. Kadokura, T. V. Colby, J. L. Myers, M. S. Allen, C. Deschamps, V. F. Trastek, and P. C. Pairolero Pathologic comparison of video-assisted thoracic surgical lung biopsy with traditional open lung biopsy J. Thorac. Cardiovasc. Surg., March 1, 1995; 109(3): 494 - 498. [Abstract] [Full Text]