Single-port sympathectomy for palmar hyperhidrosis with Vasoview Hemopro 2 endoscopic vein harvesting device

Ng, Calvin S.H.; Yeung, Eugene; Wong, Randolph H.L.; Kwok, Man Ki

doi:10.1016/j.jtcvs.2012.06.020

Cited by 15 publications

(10 citation statements)

References 5 publications

(5 reference statements)

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“…Uniportal video-assisted thoracic surgery (VATS) is constantly evolving and becoming increasingly popular (1,2); however, wedge resection of small pulmonary groundglass opacities (GGOs) (<15 mm) is very challenging, especially deeply situated subpleural GGOs, by means of uniportal VATS. The habitual practice of palpation is often inconclusive due to the lack of solid lung background.…”

Section: Introductionmentioning

confidence: 99%

Uniportal video-assisted thoracic surgery resection of small ground-glass opacities (GGOs) localized with CT-guided placement of microcoils and palpation

et al. 2016

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Although uniportal video-assisted thoracic surgery (VATS) is becoming more popular, it's still very challenging to conduct a wedge resection of small pulmonary ground-glass opacities (GGOs), especially deeply situated subpleural GGOs, via uniportal VATS. We successfully performed thirteen uniportal VATS wedge resections through an approach that combines radiologically guided microcoil localization with palpation, and we encountered no complications related to the new approach. Based on our experience, a combination of CT-guided microcoil localization with palpation in uniportal VATS for deeply situated subpleural GGOs is a safe and effective procedure for accurate diag¬nosis and resection of indeterminate The core of a 150-mm-long Chiba biopsy needle was removed. A 30-mm-long, 0.035-inch-diameter fiber-coated stainless steal microcoil was pushed into the Chiba needle by using the stiff end of a 40-cm-long, 0.018-inch-diameter guidewire from a micropuncture catheter introducer set. After the microcoil was loaded into the needle, a hemostat was used to mark the pusher wire at one point-the length necessary to eject the entire 30-mm-long microcoil from the Chiba needle.All microcoil localizations were performed or closely supervised by one interventional chest radiologist with 20 years' experience. With CT guidance, the loaded Chiba needle was pushed through and 5 mm deep to the suspicious nodule. The premeasured guidewire was advanced into the Chiba needle up to the mark at which the hemostat was placed, and the 30-mmlong microcoil was deployed into the lung parenchyma, where it assumed a tightly coiled ball configuration just beyond the tip of the needle. A localizer CT scan was obtained to confirm the microcoil deployment. The empty needle and guidewire assembly were then withdrawn (Figure 1). During the localization, we preferred a relatively longer travel from entry point of visceral pleura to the lesion to prevent microcoil displacement to the cavity. To avoid dislocation, we push in the guiding wire when retrieving the Chiba needle to keep the microcoil relatively immobilized. When Chiba needle is retrieved and not in contact with the microcoil, we then pull out the guiding wire.A postprocedural larger-volume CT scan was obtained to assess the final position of the microcoil relative to the nodule and the pleural space and to test for the presence of postprocedural hemorrhage, as indicated by new airspace consolidation and pneumothorax. The patient was then transferred to the preoperative area, where he or she waited for 1-4 hours before undergoing surgical resection of the nodule in the operating room. There were two pneumothoraxes and one intrapulmonary hemorrhage, post-procedurally. Surgical techniqueAfter being placed under general anaesthesia with double lumen endotracheal intubation, the patient is positioned in a lateral position. The surgeon stands anterior to the patient with the assistant and scrub nurse opposite to him, and the screen at the patient's head. The incision is made on the an...

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Section: Introductionmentioning

confidence: 99%

Uniportal video-assisted thoracic surgery resection of small ground-glass opacities (GGOs) localized with CT-guided placement of microcoils and palpation

et al. 2016

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“…3 Since then, more modern versions of the device, the Vasoview Hemopro and Hemopro 2, have been introduced, which use a dissecting grasper with Starion technology that has a gradated thermal tip and pressure to cut and coagulate without electric current passing through tissues. 4 Consequently, collateral thermal tissue damage is minimized, 7 which in the context of sympathectomy may potentially reduce the risk of inadvertent superior sympathetic chain injury and associated complications including Horner's syndrome. In our experience, all three versions of the VasoView device are user friendly for sympathicotomy, with no difference in complication or operating duration among the systems.…”

Section: Discussionmentioning

confidence: 99%

Single-Port Vasoview Sympathectomy for Palmar Hyperhidrosis: A Clinical Update

Lau

Wong

et al. 2014

Journal of Laparoendoscopic & Advanced Surgical Techniques

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“…VTS with 2 or 3 small incisions is the most common technique used. The single port VTS is a novelty having excellent cosmetic results and improved satisfaction (2,11,16,17). We have been using this single port technique for all age groups with similar advantages for the last 2 years.…”

Section: Discussionmentioning

confidence: 99%

Single port thoracoscopic sympathectomy for primary palmar hyperhidrosis in adolescence

Günal¹,

Özpolat²,

Günal³

et al. 2014

Turk J Med Sci

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IntroductionHyperhidrosis is a health problem having negative effects on adolescent quality of life, affecting daily social activities or educational life. Primary focal hyperhidrosis (PFH) is often observed in axillary, palmar, plantar, and craniofacial regions and more than one region can be involved (1). There is still no consensus about the mechanism of hyperhidrosis in adolescents. The prevalence is reported as 0.6%-1.0% in young populations (2).Thoracoscopic sympathectomy, which is accepted as the gold standard for the permanent cure of PFH, is achieved by interruption of impulse transmission from sympathetic ganglia to the sweat glands (2,3). A few studies reported that surgery should be performed before adulthood, emphasizing that adolescents tolerate side effects better than adults (1,3-7).Among adolescents, primary palmar hyperhidrosis (PPH) is widely disregarded and undertreated. To the best of our knowledge, there is no study reporting PPH treatment with single port video-assisted thoracoscopic sympathectomy (VTS) in adolescents in Turkey. Herein, we report our experience and short-term outcomes of this treatment, where the symptom resolution, intraoperative and postoperative complications, patient satisfaction, and subsequent compensatory sweating (CS) are analyzed. Materials and methodsSeven adolescents who underwent VTS for PPH between March 2011 and July 2012 were included. The indications for operation in our patients were chosen according to the Multi-Specialty Working Group on the Recognition, Diagnosis, and Treatment of Primary Focal Hyperhidrosis criteria: focal, visible, excessive sweating of at least 6 months in duration without an underlying cause, plus at least 2 of the following characteristics: a distribution that is bilateral and relatively symmetric, impairment of daily activities, at least 1 episode per week, onset before 25 years of age, family history of PFH, or focal sweating that ceases during sleep (8).Data were collected retrospectively. The chief complaint of patients was palmar hyperhidrosis. Additional axillary hyperhidrosis was present in 6 patientsAim: Hyperhidrosis is defined as excessive sweating beyond the physiologic needs of a person. Palmar hyperhidrosis in the adolescent period may have an impact on school work and may cause psychological problems. In this study we aim to increase awareness of this disregarded problem. Materials and methods:We explicated the early outcomes of 7 consecutive adolescents, where single port video-assisted thoracoscopic sympathectomy was performed for primary palmar hyperhidrosis. Patients were evaluated for symptom resolution, which was defined as complete dryness, patient satisfaction, operative complications, and compensatory sweating.Results: In total 13 thoracoscopic procedures were done in 7 adolescents, consisting of 4 girls and 3 boys (median age = 16 years). Thoracoscopic sympathectomy achieved immediate complete dryness and all were very satisfied with the outcome of the procedure. Compensatory sweating was defined as mild by 4...

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Single-port sympathectomy for palmar hyperhidrosis with Vasoview Hemopro 2 endoscopic vein harvesting device

Cited by 15 publications

References 5 publications

Uniportal video-assisted thoracic surgery resection of small ground-glass opacities (GGOs) localized with CT-guided placement of microcoils and palpation

Uniportal video-assisted thoracic surgery resection of small ground-glass opacities (GGOs) localized with CT-guided placement of microcoils and palpation

Single-Port Vasoview Sympathectomy for Palmar Hyperhidrosis: A Clinical Update

Single port thoracoscopic sympathectomy for primary palmar hyperhidrosis in adolescence

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