A Comparison Between Conventional and Thoracoport Technique for Tube Thoracostomy in Pneumothorax

Background: Pneumothorax is a medical emergency wherethere is an abnormal collection of air in the pleural space. Afterconfirming the diagnosis chest tube is placed into the pleuralspace which allows the air or fluid to escape from the pleuralspace. Newer methods of tube thoracostomy using Seldingerand thoracoport techniques are replacing the conventionalmethod. The TP technique is said to be safer, faster whencompared to the conventional one.Aim: To compare the time required for the tube thoracostomyand whether tube thoracostomy can be performed by a singlemedical person without assistance. As well as complicationrates using both conventional and thoracoport techniques.Materials and Methods: Out of total 80patients, 40 patientsunderwent tube thoracostomy using thoracoport and remaining40 by conventional method randomly for pneumothorax.Results: Mean procedural time by conventional was highwhen compared to thoracoport technique. Need for assistanceand complications were high in conventional to thoracoportmethod.Conclusions: Tube thoracostomy using thoracoport has astatistical advantage over conventional technique in terms ofprocedural duration, need for assistance and complicationsand this method will definitely revolutionise the emergencymanagement of pneumothorax.

A Minimally Invasive Lumbar Spine Surgery Technique Using a Modified Thoracoport: Proposal of a New Tubular Retractor

Recently the trend of surgical procedure for treatment of lumbar benign disease is a minimally invasive surgery due to small incision, minimal blood loss, and a short hospital day. By using a microscope or an endoscope, and other surgical equipment, a delicate manipulation in a narrow space became feasible, consequently, to secure a wider view with small incision, appropriate retractors are required. But the various tubular retractor systems are expensive and have some problems. We modified Thoracoport (Auto Suture Co., Norwalk, CT) by making a window at the distal end of trocar and used it as a tubular retractor in surgical procedure for treatment of lumbar benign disease. This modified tubular retractor is docked closely on the curved lamina and provides a wider view. We used it as a tubular retractor also in lumbar bilateral decompression involving a unilateral approach. But this trocar has the limited sizes (diameter and length), and also it is difficult to fix the retractor or change the direction of retractor. And then, we propose a more modified Thoracoport with various sizes and attaching the settling holders to the head of tubular retractor to be able to fix the retractor.