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Thoracoscopic Lobectomy. George W. Holcomb, III, M.D., MBA Children’s Mercy Hospital Kansas City, Missouri. Indications. Intralobar sequestration CCAM Bronchiectesis Lobar emphysema Other lobar conditions. Principles. Single lung ventilation Double lumen ETT
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Thoracoscopic Lobectomy George W. Holcomb, III, M.D., MBA Children’s Mercy Hospital Kansas City, Missouri
Indications • Intralobar sequestration • CCAM • Bronchiectesis • Lobar emphysema • Other lobar conditions
Principles • Single lung ventilation • Double lumen ETT • Contralateral mainstem intubation • Bronchial blocker
Principles • Lateral patient position • Monitor over patient’s shoulder • Surgeon/assistant on anterior side of patient • Work medial to lateral; do not flip lung over • Do not hesitate to convert
Equipment • Harmonic scalpel • LigaSure • Stapler • Clips
CMH Experience • 14 Pts • 12 Successful • 2 Conversions