Video-guided tube thoracostomy with use of an electrical nonfiberoptic endoscope.

Abstract

Tube thoracostomy is a common and generally safe procedure. However, potential hazards can occur during placement of the chest tube. Inasmuch as unexpected injuries may arise from tube thoracostomy, we propose a novel video-guided method. We used an independent complementary metal oxide semiconductor image sensor with a processing chip to obtain a front view image of the chest cavity. The device is connected to an aluminum shaft with four small light-emitting diode crystals in the tip, and a detachable small monitor with a battery inside. The apparatus is small and can be used to direct vision-guided tools in tube thoracostomy. We performed video-guided tube thoracostomy in 6 patients with pleural adhesions. All patients experienced good tolerance to the procedure and had no immediate adverse events. The thoracostomies were performed by a single surgeon with good acceptability, and each procedure was completed in less than 10 minutes. In some cases of pleural adhesion, the video-guided thoracostomy may be a safer alternative to non-image guided tube thoracostomy.