Introduction of thoracoscopic esophageal surgery

By | March 22, 2012

Introduction thoracoscopic esophageal surgery (1) thoracoscopic esophageal surgery indications. Currently, most scholars believe that thoracoscopic surgery for esophageal carcinoma is not only deep myometrial invasion in early esophageal carcinoma patients, cardiopulmonary function can not be tolerated for radical surgery of traditional thoracotomy may be considered a mirror Resection of thoracic tumors.
(2) preoperative examination. Thoracoscopic surgery for esophageal cancer patients, in addition to routine preoperative X-ray dam meal examination, endoscopy, but also to the line CT, esophageal ultrasound examination to be necessary, once the tumor has invaded the esophageal muscle, in addition to heart and lung function poor patients, in principle, to consider assisted thoracic surgery.
(3) anesthesia. Thoracoscopic esophageal cancer with tracheal lumen intubation, unilateral left lung ventilation anesthesia. Because unilateral left lung ventilation, collapsed right lung surgery when, mediastinal little swing for the operation provides a good surgical field.
Introduction of thoracoscopic esophageal surgery (4) cervical, abdominal incision assisted thoracoscopic surgery for esophageal cancer with the surgical method: chest incision and position. After double-lumen intubation the patient, take left lateral position, slightly leaning forward, leaning forward to make the right lung surgery, to maximize the exposure of the posterior mediastinum and esophagus. Routine to do three 5mm 10mm length and a long incision, the first incision in the right chest, 8 or 9 intercostal space posterior axillary line; second, third, fourth incision in the right chest with a suspension or esophageal 6 lower esophagus, electricity hook separation (or ultrasonic knife) to esophageal cancer free top 10cm, into the endoscopy, esophageal intestinal clamp after clamp off the premises. The lower esophagus from the abdomen and tumor out.
(5) in tumor cut 5-10cm below the stomach, the stump with 3-0 absorbable continuous suture line, leaving a small opening into stapler. Or all of the off stump, stapling the stomach into another stoma.
(6) into the left chest cavity auto-suture device, do the pockets of esophageal stump suture, and then at the hole from the chest muscle nail stapler into the esophageal stump cavity cap, purse suture ligation.
(7) stapler nails with a sharp piercing from the anterior wall of the greater curvature of the stomach, the stomach muscles from the brain into the hole at the chest, and the stapler head of a nail embedded access, check the surrounding tissue is not embedded, the tightened stapling and firing.
(8) remove the small opening from the stomach stapled stump, check the removal of stomach and esophageal ring is complete. If complete, the tube into the stomach, with 3-0 absorbable continuous suture line gastric stump small mouth.
Introduction of thoracoscopic esophageal surgery (9) Thoracoscopy anastomotic integrity, the posterior axillary line incision in the chest lead chest tube into the other incisions sutured the chest. Last layered suture abdominal incision.

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