Laparoscopy lung: characteristics, indications and contraindications
Light is one of the vital organs without which the body cannot exist. Any malfunctioning of the lungs significantly affects the General health, requiring immediate treatment of pulmonary pathologies. In addition to drug therapy often have to resort to thoracic surgery, one method of which is laparoscopy.
Thoracic surgery – why is it special?
Specialization of thoracic surgeons is the elimination of violations localized in the chest. One of the most demanded intervention associated with lung pathology, requiring radical action in the form of partial or full removal of the functional part of the body. To conduct such operations possible as the traditional way (thoracotomy), in which to gain access to easy the incision is performed in the area between the ribs and through minimally invasive techniques. These include popular today laparoscopy.
Laparoscopic method is used during diagnostic procedures. To do this, use a tool called a thoracoscope, which visually inspect the pleural cavity and the lung surface without direct contact with the body. Also during thoracoscopy samples are taken for biopsy is the removal of suspicious pulmonary nodules.
When the indicated lung resection
If a particular part of the lung can no longer cope with her assigned function of gas exchange, there is a need for surgical intervention. To provoke such a breach is capable of the following factors.
- Inflammatory or infectious process, the result of which was the destruction of lung tissue.
- The development of benign or malignant tumors, resulting in degeneration of lung tissue.
- The presence in the body of the cyst is a hollow education. It can be congenital or acquired.
- Disease in which the tissues of the lung develop purulent processes causing the disintegration of the tissues.
- Traumatic injuries of the organ of respiration (burns, bruises).
Options for surgical intervention
Surgery as the main treatment of lung diseases, especially if diagnosed with cancer at an early stage. Complementing the operation of special technologies, could deal with the tumors and the long-term process, in this case, along with the cancer education is removed adjacent healthy tissue and thoracic lymph nodes, located on one side of a developing pathology.
Regardless of the method chosen, after the operations, the difficulty of breathing during a certain period of time, until the restoration of the lung tissue. To help expedite the process performed during rehabilitation breathing exercises.
The following types of transactions.
- Wedge resection – the goal of the intervention is the removal of a small part of the lung, where tumor formation. At the same time incising the surrounding healthy tissue.
- Segmental resection in the form of lobectomy and pneumoectomy. In the first case, remove the entire lobe of the lung along with malignant tissue and draining lymph nodes. In the end, significantly reduced the risk of recurrence of cancer and development of metastases. If pneumonectomy is the removal of the entire lung with tumor cells.
For the first two options is possible as a thoracotomy with a large incision in the chest and sparing laparoscopy.
Laparoscopy as an alternative to thoracotomy
Laparoscopy of the lung is performed by minimal invasive intervention. When using laparoscopic way into the chest through the punctures are special tools on the end of one of which there is a camera that provides high-quality visualization of the treated area. The use of this technique is justified if the tumor is small in size. It is possible to speak about high probability of a successful outcome of the operation, as modern technology helps to remove, except for prolonged air leaks from the alveoli and bleeding.
Laparoscopy is performed using General anesthesia. Also requires installation of the epidural catheter required in the postoperative period for the introduction of anesthetics, contributing to alleviate the condition after surgery. To ensure the outflow of fluid from the operated region is set to couple the drain pipes. By the time the procedure takes about two hours, and by the end of the operation, the patient regains consciousness, begins to breathe independently.
Features laparoscopy with wedge resection of lung
Laparoscopy (thoracoscopy) of the lung, carried out by the method wedge resection, performed if not diagnosed nodes whose diameter is a maximum of 3 cm, When the localization of entities becomes the outer third of the lung, there is minimal risk of damage to the bronchi and segmental vessels. Not recommended for such a surgical intervention, if confirmed malignant nature of the identified education.
Before the operation is necessarily performed computed tomography, where the aim is the precise determination of the location of the node. Directly laparoscopy begins with the introduction of a double lumen endotracheal tube, after which the subject of resection of the lung is excluded from ventilation by mechanical it wears off. Additionally, you may need to insufflation (injection of finely divided medicinal substance) when it fails to provide adequate decompression of the body.
In most situations for wedge resection is used at least 3 of the trocar. One (the size of the puncture – 10 mm) is injected between the seventh and eighth ribs, focusing on the mid-axillary line, and the second between the fifth and sixth below the chest muscles. The third (and possibly fourth) sections localized near the armpit or behind her. In this embodiment, laparoscopy involves the cutoff is fixed between the clamps of the plot of the lung tissue and applying the mattress sutures. Due to the wedge shape of the plot was excised pass along the duct, arteries and veins.
The choice of laparoscopy in thorascopically wedge resection due to the minimal risk of postoperative complications and a good prognosis. The duration of hospital stay is a maximum of 5 days, after which you can return to normal life, mindful of the need for regular control of the operated lung by means of x-rays. During the recovery period, which can last in some cases up to two months, possible weakness, soreness at the site of surgical intervention and shortness of breath or difficulty breathing.
Lung cancer, like lung pathology requiring resection partial or full version, is the third most common cancer, which affects not only active smokers. Complete examination, computer tomography, assessment of the cardiovascular system allow you to pick the most effective method of surgical intervention. Of course, laparoscopy light becomes the preferred option due to the reduction of terms of rehabilitation and low complications. Therefore, it is desirable as early as possible to respond to warning signs, avoiding development process.