Mark McCollum

19 statements · 1 topic

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I would just underscore what Nick said, and, and this is a procedure that's useful in a, in a low risk to conversion thoracoscopic case, and, and, uh, VTS is the perfect case for it. Any other, uh, low risk pleural based, uh, lesion case, if you were looking for a biopsy or something superficial, superficial. Uh, wedge resection, I think it would be applicable as well. But again, uh, if there's a high risk of conversion or a difficulty with exposure, I would probably go with the traditional decubitus positioning.
quote · Spontaneous Pneumothorax
I agree with the, uh, the pleurectomy and the talc, um, are very painful postoperatively, and if you've ever had to re-operate in a chest that's had talc in it, you'll never do it again, uh, and I don't want the whole lung frozen
quote · Spontaneous Pneumothorax

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Mark's statements about Spontaneous Pneumothorax 19 statements

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Supine Positioning for Bilateral VATS: Pediatric Surgery Difficult...

Statement Supine VATS is useful in low-risk to conversion thoracoscopic cases and applicable for low-risk pleural-based lesion cases, superficial wedge resections, or biopsies. Open
Statement If there's a high risk of conversion or difficulty with exposure, traditional decubitus position is preferred over supine. Open
Statement A double-lumen tube was used with positive pressure in the chest being worked on, providing great exposure. Open
Statement Mechanical pleurodesis was performed from about the 5th rib intercostal space up to the apex, circumferentially, and was as easy as the standard decubitus approach. Open
Quotation if you've ever had to re-operate in a chest that's had talc in it, you'll never do it again, uh, and I don't want the whole lung frozen Open
Statement Pleurectomy and talc pleurodesis are very painful postoperatively, and re-operating in a chest that has had talc is extremely difficult due to the entire lung being frozen. Open
Statement In the presented case, the area where the previous bleb had spontaneously erupted was well adhered to the apex of the chest when the right side was started. Open
Statement Mechanical pleurodesis works effectively by causing only the apex of the lung to adhere, which may be sufficient to prevent tension pneumothorax without freezing the entire chest. Open

Tricks - Supine Positioning For Bilateral VATS

Statement Supine VATS is useful in low-risk-to-conversion thoracoscopic cases; any low-risk pleural-based lesion case for biopsy or superficial wedge resection would be applicable, but if there's high risk of conversion or difficulty with exposure, traditional decubitus positioning is preferred. Open
Quotation I would just underscore what Nick said, and, and this is a procedure that's useful in a, in a low risk to conversion thoracoscopic case, and, and, uh, VTS is the perfect case for it. Any other, uh, low risk pleural based, uh, lesion case, if you were looking for a biopsy or something superficial, superficial. Uh, wedge resection, I think it would be applicable as well. But again, uh, if there's a high risk of conversion or a difficulty with exposure, I would probably go with the traditional decubitus positioning. Open
Statement In the presented case, a double-lumen tube was used with positive pressure in the chest being worked on, providing great exposure. Open
Statement Mechanical pleurodesis was performed circumferentially from about the 5th intercostal space up to the apex, which was as easy as the standard approach with decubitus positioning. Open
Statement The patient was moved to the side edge of the bed to allow full mobility of the surgeons' hands. Open
Statement Mechanical pleurodesis works effectively because you just need the apex of the lung to stick up, not the whole lung frozen. Open
Statement In the presented case, when starting on the right side, the area where the previous bleb had spontaneously erupted was well adhered to the apex of the chest. Open
Statement Pleurectomy and talc are very painful postoperatively, and if you've ever had to re-operate in a chest that's had talc in it, you'll never do it again because the whole lung becomes frozen. Open
Quotation I agree with the, uh, the pleurectomy and the talc, um, are very painful postoperatively, and if you've ever had to re-operate in a chest that's had talc in it, you'll never do it again, uh, and I don't want the whole lung frozen Open
Quotation and that's why the mechanical pleurodesis works effectively. I just need the apex of that lung to stick up. Open
Quotation And if you notice in that video, when we started on the right side, just the area where the previous bleb had spontaneously erupted was well adhered to the apex of the chest. Open