Ultrasound Guided Thoracoscopic Dental Extraction

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Author: Samir Pandya
Published:
Specialties: Cardiothoracic Surgery, Pediatric Surgery
Schools: New York Medical College
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Basic Info

Contributors: Rodrigo Ruiz and Adele Brudnicki

We present a minimally invasive approach for removal of an aspirated tooth that was not extractable via rigid / flexible bronchoscopy.  The multimodal technique results in a successful extraction via non-anatomic wedge resection of the affected portion of the lung and thereby obviates the need for a formal lobectomy.

Advanced

Procedure

Ultrasound Guided Thoracoscopic Wedge Resection of the lung for aspirated tooth

Indications

Extraction of aspirated foreign bodies that are causing pulmonary disease such as pneumonia and are unobtainable via bronchoscopy. May also use the technique for thoracoscopic metastatectomy.

Contraindications

Hemodynamic / respiratory instability. Non echogenic pulmonary lesions

Instrumentation

Setup

Lateral decubitus

Preoperative Workup

CT scan of Thorax. Rigid / Flexible bronchoscopy.

Anatomy and Landmarks

Optical trocar in 5th intercostal space at mid axillary line. One port on either side of the optical trocar.

Advantages/Disadvantages

Minimally invasive. Targeted resection. Avoids thoracotomy and lobectomy.

Complications/Risks

Pneumothorax. Staple line failure. Bleeding from staple line.

Disclosure of Conflicts

Pneumothorax. Staple line failure. Bleeding from staple line.

Acknowledgements

None

References

S. Pandya, R. Ruiz and A. Brudnicki. Ultrasound guided thoracoscopic dental extraction.American Surgeon. 79(9): 891-2. September 2013. PMID 24069984

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