Can Intrapleural Tissue Plasminogen Activator and Deoxyribonuclease Be Used to Treat Persistent Hemothorax After Robotic Lobectomy?

Hemothorax is a serious complication following thoracic surgery, often resulting from vessel injury or rib fractures, and is typically managed with chest tube drainage. Persistent or loculated hemothorax, referred to as retained hemothorax, may require more invasive interventions, such as thoracotomy. Although the intrapleural administration of tissue plasminogen activator (tPA) and deoxyribonuclease (DNase) has shown promise in managing pleural infections, its use for hemothorax remains controversial due to bleeding risks.

Mediastinal Paraganglioma: A Challenging Surgical Approach.

Mediastinal paragangliomas, though rare, present significant surgical challenges due to their proximity to critical vascular structures within the mediastinum. This case report discusses the management of a patient with an incidentally discovered non-functional mediastinal paraganglioma. The tumor's location necessitated meticulous preoperative planning and intraoperative navigation to prevent vascular injury.

Near infrared fluorescence imaging with ICG in TECAB surgery using the da Vinci Si surgical system in a canine model.

Background: This study assessed the clinical utility of near-infrared fluorescence imaging using indocyanine green in off-pump beating heart total endoscopic and robotic-assisted coronary artery bypass using the fluorescence imaging system for the da Vinci Si on a canine model for vessel identification, graft patency, and correlation of graft patency with ultrasound transit-time flow measurement probe.

Methods: Beating heart total endoscopic robotic-assisted coronary artery bypass was performed on eight canine using indocyanine green and fluorescence imaging to identify the internal mammary artery prior to harvesting, the coronary vessel anatomy, and the patency of the beating heart total endoscopic coronary artery bypass anastomosis. Three to four injections of indocyanine green with a dose of 1.

Robotic "haircut" mitral valve repair: posterior leaflet-plasty.

Posterior leaflet prolapse has been repaired traditionally by leaflet resection with or without a sliding annuloplasty. However, substantial annular calcification, thin leaflets, or deficient P1 or P3 scallops can complicate this technique. Annular closure after large posterior leaflet resection introduces substantial radial stress even in the presence of a sliding annuloplasty.

Robotic mitral valve repairs requiring reoperations.

Objective: : Robotic mitral valve (MV) repairs are performed at many institutions. Repair failures have been attributed to the challenging technology and potentially to the use of annuloplasty band anchoring U-clips. The purpose of this study was to characterize causes of robotic MV repair failure.