Thoracic discectomy using video assisted thoracoscopy

Abstract

Study design: The applicability of using video assisted thoracoscopic surgery (VATS) to resect thoracic discs was investigated. A laboratory study was conducted using two human cadavers and three live pigs as surgical specimens. A total of nine thoracic levels were decompressed.

Objective: To study the feasibility of performing thoracic resections using VATS.

Summary of background data: VATS has been used by thoracic surgeons since 1991 to resect pulmonary lesions. As far as we know, VAT has not yet been used to resect thoracic discs.

Methods: Surgical resections of nine disc levels were carried out in two human cadavers and three anesthetized pigs. VATS was used to provide the surgeon with visualization of the surgical site. Large thoracotomy incisions were not necessary.

Results: Five of seven cadaver disc spaces and two of three porcine disc spaces were adequately evacuated of disc material. One episode of dural violation occurred. One animal died during the procedure from an anesthetic complication.

Conclusion: VATS provides a useful means of performing thoracic discectomies using a small thoracotomy incision. The decrease in invasiveness provided by this new technology may reduce operative morbidity, hospitalization time, and costs. More work is needed, especially in the design of instrumentation, before this becomes a viable alternative to current surgical procedures.