ISMICS - Tecs (totally Endoscopic Cardiac Surgery) For Large Pericardial Cyst Removal.

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Tecs (totally Endoscopic Cardiac Surgery) For Large Pericardial Cyst Removal.
Evandro C. Lopes, Cl�udio A. C�sar, Gustavo B. Perez;
Cardio Assist, CAMPO GRANDE - MS, Brazil

BACKGROUND: Pericardial cysts are rare mediastinal masses of congenital etiology. Very large or complicated cysts are preferentially treated by open surgical excision. We present two cases of resection of large pericardial cysts with a completely endoscopic approach. METHODS: After general anesthesia with double lumen intubation and single lung ventilation, myofascial block (PECS) was performed. The patient was positioned in the right lateral decubitus position at 90 degrees. Three portals were positioned: in the 2nd right intercostal space in the mid-axillary line for the camera; in the 4th right intercostal space in the mid- axillary line and in the 6th right intercostal space in the anterior-axillary line for working portals. Pericardial cyst located, endoscopically dissected (first case with monopolar hook and second case with harmonic sealer) and then removed. After removing the cyst, we positioned the chest tube, removed the trocars and sutured the skin.
RESULTS: Both patients were extubated in the operating room and taken to the ICU. After a few hours we removed the drain and the patient walked. The next day, in the morning, the two patients discharged home with no restrictions. CONCLUSIONS: Totally endoscopic cardiac surgery for resection of pericardial cysts is a simple, low-cost procedure with excellent curative results.

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