Journal of Minimal Access Surgery

HOW I DO IT DIFFERENTLY
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Year : 2009  |  Volume : 5  |  Issue : 2  |  Page : 49--51

Video-assisted thoracic surgery for superior posterior mediastinal neurogenic tumour in the supine position

Laleng M Darlong 
 Department of Surgery, North East Indira Gandhi Regional Institute of Health & Medical Sciences, Shillong, India

Correspondence Address:
Laleng M Darlong
Department of Surgery, North East Indira Gandhi Regional Institute of Health & Medical Sciences (NEIGRIHMS), Shillong, Meghalaya - 793 018
India

Video-assisted thoracic surgery (VATS) for a superior posterior mediastinal lesion is routinely done in the lateral decubitus position similar to a standard thoracotomy using a double-lumen endotracheal tube for one-lung ventilation. This is an area above the level of the pericardium, with the superior thoracic opening as its superior limit and its inferior limit at the plane from the sternal angle to the level of intervertebral disc of thoracic 4 to 5 vertebra lying behind the great vessels. The lateral decubitus position has disadvantages of the double-lumen endotracheal tube getting malpositioned during repositioning from supine position to the lateral decubitus position, shoulder injuries due to the prolonged abnormal fixed posture and rarer injuries of the lower limb. There is no literature related to VATS in the supine position for treating lesions in the posterior mediastinum because the lung tissue falls in the dependent posterior mediastinum and obscures the field of surgery; however, VATS in the supine position is routinely done for lesions in the anterior mediastinum and single-stage bilateral spontaneous pneumothorax. Thus, in the selected cases, «SQ»VATS in supine position«SQ» allows an invasive procedure to be completed in the most stable anatomical posture.


How to cite this article:
Darlong LM. Video-assisted thoracic surgery for superior posterior mediastinal neurogenic tumour in the supine position.J Min Access Surg 2009;5:49-51


How to cite this URL:
Darlong LM. Video-assisted thoracic surgery for superior posterior mediastinal neurogenic tumour in the supine position. J Min Access Surg [serial online] 2009 [cited 2020 Feb 16 ];5:49-51
Available from: http://www.journalofmas.com/article.asp?issn=0972-9941;year=2009;volume=5;issue=2;spage=49;epage=51;aulast=Darlong;type=0