V-02. Video-Assisted Thoracoscopic Repair of a Case of Boerhaave Syndrome Showing Superior Debridement and Lavage of Mediastinum and Thoracic Cavity

Résumé fourni par la source

Abstract Topic Benign Disease: Esophageal Surgery Video Description This video shows Video Assisted Thoracoscopic Surgery (VATS) repair of a patient with Boerhaave Syndrome. This video clearly shows the benefits of using VATS as a mode of repair especially with patients with early presentation including better visualization of the perforation site, easier access of laparoscopic instruments to repair the defect, easier irrigation and debridement of the mediastinum and thoracic cavity. The video starts with localizing the esophagus and dissecting the esophagus from the surrounding structures including the aorta behind it. After removing the inflammatory collection and exudate surrounding the esophageal perforation site, the esophagus could be localized, and the perforation site was seen. The extend of the muscle perforation can be seen but not the mucosal layer. The muscle layer perforation was extended caudally to have better visualization of the size of the mucosal layer defect. The mucosal layer was closed with interrupted 4-O vicryl first and then the muscle layer was closed with interrupted 3-O PDS. The mediastinum and thoracic cavity was irrigated with copious water. Finally, a large bore chest drain was inserted next to the repair site. In view of VATS repair, the outcome of this patient is associated with less pain, faster recovering, shorter ICU stay and less postoperative intervention.

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