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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Loading...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.
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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