Thoracoscopy using a substernal handport for palpation

The Annals of Thoracic Surgery
Frank C Detterbeck, Thomas M Egan

Abstract

A substernal handport allows palpation of the lung and thus circumvents one of the major limitations of thoracoscopy. This approach has been used in 24 consecutive patients, primarily during planned metastasectomy or when palpation was needed for deeper or smaller lesions that were difficult to find. No long-term complications from this procedure were noted, and the 3 early complications were either minor or unrelated to the procedure. This approach allowed adequate resection to be accomplished by a less invasive approach in 67% of patients, although conversion to an open procedure was necessary in 33% of patients for anatomic and technical reasons. Among the 16 patients who underwent this procedure alone, the median length of stay in the hospital was 3 days. The rate of incomplete resection and of recurrence after metastasectomy was comparable to that for an open approach. Our experience documents that a substernal handport is safe, does not compromise the ability to perform an adequate metastasectomy, and allows biopsy of lesions that are otherwise not amenable to a minimally invasive approach. This technique should be included in the standard armamentarium of approaches for thoracic surgery.

References

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Citations

Jul 6, 2014·Current Treatment Options in Oncology·Francis C Nichols
Jun 5, 2010·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Tamas F MolnarAkif Turna
Oct 20, 2010·The Surgical Clinics of North America·Yifan Zheng, Hiran C Fernando
Nov 25, 2004·The Annals of Thoracic Surgery·Alden M ParsonsLeonard A Parker
Nov 27, 2007·The Annals of Thoracic Surgery·Alden M ParsonsFrank C Detterbeck
Nov 26, 2009·The Annals of Thoracic Surgery·Loretta Erhunmwunsee, Thomas A D'Amico
Oct 26, 2005·The Annals of Thoracic Surgery·Tommaso C MineoEugenio Pompeo
Mar 7, 2015·Critical Reviews in Oncology/hematology·Jean Yannis PerentesMichel Gonzalez
Apr 23, 2016·The Journal of Thoracic and Cardiovascular Surgery·Tommaso Claudio Mineo, Vincenzo Ambrogi
Mar 4, 2014·Asian Cardiovascular & Thoracic Annals·Khalid Turki AlthagafiKhaled Manae Alkattan
Aug 14, 2012·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Frank C DetterbeckMarcin Zielinski
Apr 24, 2014·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Anthony W KimFrank C Detterbeck

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