Instrumentation and Technique for Pediatric Thoracoscopy

Abstract

Thoracoscopy is now the preferred operative technique for many thoracic disorders in children, in part because of the development of better instrumentation. Reusable instruments are used increasingly to lower costs. There are few absolute contraindications to thoracoscopy in children, one of the few being complete pleural symphysis. Preoperative imaging is important for surgical planning and sometimes includes CT or MRI. The most effective anesthetic technique for the particular procedure is then selected; general anesthesia is used in most cases. Spontaneous breathing is desirable to facilitate maintenance of the pneumothorax. Proper positioning on the operating table is critical to success. Many thoracoscopic procedures are now possible in children, and pediatric surgeons must be familiar with its use.