- Meeting abstract
- Open Access
Video-thoracoscopic resection of lung metastases using the Nd:YAG Laser LIMAX® 120
© Kirschbaum et al. 2015
- Published: 16 December 2015
- Lung Metastasis
- Pulmonary Metastasis
- Parenchymal Lesion
- Monofilament Suture
- Entire Lung
In general, resection of pulmonary metastases by laser is performed by means of a thoracotomy. As an alternative, we developed a video-assisted technique that allows palpating of the entire lung as well as resection of the pulmonary metastases by laser.
We report our first experiences with this technique.
10 patients (7 ♂, 3 ♀; age: 22 - 83 years) were diagnosed with pulmonary metastases of different primary tumours. The procedure begins with creation of a mini-thoracotomy at the level of the 5th ICR, approximately 4 cm in length. No rib retractor is applied, but wound protection film (Applied Medical, CA, USA) is used. Through a basally applied trocar, the video thoracoscope is introduced. Then the pulmonary ligament is cut and video-assisted radical mediastinal lymphadenectomy is performed. The entire lung is then palpated through the mini-thoracotomy. The respective lung metastases are identified and resected under thoracoscopic control with the Nd:YAG laser LIMAX® 120 (Gebrüder Martin & Co. KG, Tuttlingen, Germany). To this end, under visual control a hand piece with a focus distance of 3 cm is introduced at a laser power of 80 watts. Deeper parenchymal lesions are closed under video-thoracoscopic control with a monofilament suture (PDS 4-0). Usually only one intercostal drainage with additional holes is necessary. The mini-thoracotomy is closed by one pericostal suture.
The mean duration of the surgical procedure was 90 minutes. On average, 2 lung metastases per patient were removed. Histologically, the resection margins were always clear. The postoperative courses were uncomplicated; the intercostal drainages applied could be removed median on the 4th (range 3 to 6) postoperative day. All patients could be discharged symptom-free between the 5th and 6th postoperative day. Control by thoracic CT scanning after 3 months showed no evidence of pulmonary metastases.
Using the Nd:YAG laser LIMAX® 120, pulmonary metastases can be removed safely and in sano by a video-assisted procedure. Thoracotomy can thus be avoided. Nevertheless, the surgical technique described by us meets the requirements of modern metastasis surgery.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.