[Transdiaphragmatic pericardial fenestration: laparoscopic modification of the procedure].

We present a modification of the laparoscopic pericardial fenestration, an already accepted method for the treatment of the pericardial effusion caused by intrathoracic malignancies. We used this new technique in 5 patients. Laparoscopy was performed with three ports standard technique and dissection with Ultrascision was used for the fenestration of the pericardium.

Pericardial drainage using the transdiaphragmatic route: refinement of the laparoscopic technique.

Four patients with malignant pericardial fluid requiring permanent drainage are reported. A three-port video-assisted thoracoscopic surgery modification of the pericardioperitoneal shunt procedure is described, in which the Ultracision Harmonic Scalpel is used. The supraumbilically introduced camera secures direct vision for the trocars in the left and the right hypochondrium of the patient in a modified lithotomy position.