Video-assisted thoracoscopic diaphragmatic plication.

The authors demonstrate a video-assisted thoracoscopic surgical technique for diaphragmatic plication, which is used to treat acquired diaphragmatic paralysis resulting from injury to the phrenic nerve. The objective of the surgical procedure is to return the abdominal contents to their normal position and restore optimal lung expansion by reducing the size of the diaphragmatic surface. Successful diaphragmatic plication improves lung function, reduces dyspnea, and restores quality of life.

VATS sympathectomy for hyperhidrosis.

Excessive sweating in the hands, feet, and armpits is a difficult problem for people who suffer from it and is an increasingly frequent reason for consulting a thoracic surgeon. The existing medical treatments are only palliative, so primary hyperhidrosis is a definite indication for thoracic sympathectomy. This video tutorial shows in detail the 2-port videothoracoscopic surgical technique performed by our surgical team.

VATS parathyroidectomy for primary hyperparathyroidism.

Mediastinal ectopic parathyroid glands are uncommon. Traditionally, median sternotomies were performed to treat this type of lesion, resulting in a long, painful postoperative period and poor aesthetic results. With the advent of video-assisted thoracoscopic surgery, procedures were performed more frequently by this route with the same surgical and oncological results as those achieved with conventional surgery. The introduction of more sophisticated imaging studies, such as computed tomography, computed tomography-technetium-99m sestamibi scintigraphy, and single-photon emission computed tomography, facilitated identification of the exact location of the lesion. Video-assisted thoracoscopy became a safe approach and the treatment of choice for resection.

VATS tracheal resection and reconstruction.

Tracheal resection followed by reconstruction is one of the most difficult procedures in thoracic surgery. Intrathoracic tracheal injuries were usually treated by sternotomy, thoracotomy, or a combination of these techniques. In the last decade, minimally invasive surgical techniques have become an innovative trend in the treatment of thoracic tracheal conditions. Recent authors have proven the feasibility and safety of tracheal operations using video-assisted thoracoscopic surgery (VATS). This video tutorial demonstrates our technique for intrathoracic tracheal resection performed by VATS, using 2 ports, for the resection of postintubation stenosis. We show the steps performed by the surgical team and pay special attention to the maneuvers needed to operate with greater safety and achieve a tension-free reconstruction. This tutorial provides a method for treating this type of tracheal injury. It is of special interest for surgeons who specialize in the airway.