Video-assisted thoracoscopy in trauma: Case report and review of literature

Abstract

Video Assisted Thoracoscopy (VATS) like any other minimal access surgery has the obvious advantage of less surgical insult, enabling quicker recovery with its attendant reduced hospital costs and earlier return to work. The benefit of earlier return to work is much more important in developing countries. Unfortunately minimal access surgery is yet to gain popularity in trauma surgery, especially in the developing countries due to various reasons. We describe one case report where VATS was used successfully to remove an intrapleural foreign body.

Removal of cardiothoracic war-related shrapnels through video assisted thoracoscopic surgery

“…Similarly, VATS reduces postoperative pain and hospitalization and allows earlier return to work compared with thoracotomy. [1,2] Type of lung injury encountered in this case and procedure used to remove chest foreign body is very similar to those reported by Stafman et al, [3] although they removed fragment of beaker glass following laboratory explosion. First VATS operation in our patient facilitated removing foreign body, assessing lung injury, cleaning the pleura properly, and ensuring good drain placement and lung expansion.…”

“…They usually become encased in fibrous tissue and become harmless. [1,2,5] In this patient, there was a large foreign body causing pain and another that was mobile in the pericardial sac. There was risk of cardiac injury if MRI was performed.…”

“…[1,2] It has also been used to remove bullets and other foreign bodies from the pleural cavities [1][2][3] and the pericardium. [4] Presently described is the first case in the literature in which VATS was used to treat war-related shrapnel injuries to the chest wall, pericardium, lung, and pleural space in a single patient.…”

Removal of a needle from the pleural space by video-assisted throcoscopy: An unusual encounter in practice

“…[6] The standard, accepted approach to a patient with an impalement injury in whom the foreign body remains in situ is to stabilize the object until removal under circumstances in which any vascular injury can be controlled. [7] Only single case reports have been published, the largest being a series of four cases in 3 years.…”

“…VATS in thoracic trauma includes management of retained hemothorax and persistent pneumothorax, evaluation of diaphragm in penetrating thoracoabdominal injuries, evacuation of post-traumatic empyema, control of ongoing bleeding in hemodynamically stable patients and rarely for retrieval of foreign bodies, traumatic chylothorax, and rib resections. [ 6 ] The standard, accepted approach to a patient with an impalement injury in whom the foreign body remains in situ is to stabilize the object until removal under circumstances in which any vascular injury can be controlled. [ 7 ] Only single case reports have been published, the largest being a series of four cases in 3 years.…”