AVATS: Awake Video Assisted Thoracic Surgery in Complex Thoracic Procedures

Klijian AS, Kourajian PD and Gibbs MW

Department of Cardiothoracic Surgery, Sharp & Scripps Healthcare, San Diego, California, USA
Department of Anesthesia Sharp Grossmont Hospital, USA
Department of Anesthesia Franciscan Alliance, St. Francis Healthcare, Indianapolis, Indiana, USA

^*Correspondance to: Ara S. Klijian 

 PDF  Full Text DOI: 10.25107/2474-1647.1006

Abstract

Background: Traditionally, video-assisted thoracic surgery (VATS) is performed under general anesthesia with selective ventilation and endotracheal intubation. In 2014, we published our experience with awake VATS performed under local anesthesia (AVATS) extending the benefits of VATS to those unable to tolerate general anesthesia and improve outcomes.Method: Currently we reviewed a total of 494 AVATS procedures from June 2010 to January 2016, having added 201 new cases performed with AVATS to our original series. We have extended this technique to include more complex procedures, with results that surpass traditional open thoracotomies and traditional VATS under general anesthesia.Results: Procedures such as pleural biopsies, wedge resections, decortications, pleurodesis, lobectomies, bullectomies and pericardial windows were previously reported with the AVATS technique in our original paper. We have analyzed our additional volume of these procedures using AVATS and have extended the AVATS technique to repair of esophageal perforations, bronchopleural fistulae, diaphragmatic laceration and chyle leak.Conclusion: With proper patient selection and careful preoperative planning AVATS may be safely used to perform even complex thoracic surgery with equal or improved outcomes without compromise in safety.

Keywords

Awake VATS; Local sedation thoracoscopy

Cite the article

Klijian AS, Kourajian PD, Gibbs MW. AVATS: Awake Video Assisted Thoracic Surgery in Complex Thoracic Procedures. Clin Surg. 2016; 1: 1006.