FIELD: medicine.
SUBSTANCE: invention relates to medicine, namely to cardiovascular surgery. The installation of thoracoscopic ports with a diameter of 5 mm is performed in the 4th intercostal space along the anterior axillary line and in the 4th and 5th intercostal spaces along the mid-clavicular line on the right or left side of the chest, depending on the location of the effusion in the pericardium according to echocardiography. Then, an endoscope with a viewing angle of 0° with an endovideo camera is inserted into one of the ports installed in the 4th intercostal space, and working endoscopic instruments are inserted into the remaining ports. Then, under visual control, a longitudinal incision of the pericardium is made, 5-6 centimeters long, 1 cm above the projection of the phrenic nerve. The pathological fluid is removed with a vacuum aspirator and its removal from the pericardial cavity is monitored using transesophageal echocardiography. A 15F silicone drain is placed under visual control through a port in the 5th intercostal space along the midclavicular line.
EFFECT: method enables safe drainage of the pericardial cavity in case of compressive exudative pericarditis after heart surgery in case of accumulation of exudate behind the lateral or posterior surfaces of the heart, which reduces the risks of resternotomy.
2 cl, 2 ex
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Authors
Dates
2022-06-28—Published
2021-11-17—Filed