Technique of video-assisted thoracoscopic surgery for the spine: New approach

Tsung Jen Huang*, Robert Wen Wei Hsu, Hui Ping Liu, Yi Shyan Liao, Hsin Nung Shih

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

24 Scopus citations


Although video-assisted thoracoscopy has only recently been applied to treat a variety of thoracic spine lesions, many problems and difficulties are encountered with this technique owing to limited trocar space and lack of suitable endoscopic instruments. Between November 1995 and March 1996, we practiced a new approach for video-assisted thoracoscopic surgery, the 'extended manipulating channel method,' for treating 18 patients with thoracic spinal lesions endoscopically. The thoracoscopic portals were made larger (usually 3-4 cm) and placed slightly more posterior than usual, which allows use of a combination of conventional spinal instruments and video- assisted thoracoscopy to enter the chest cavity and be manipulated similar to that with techniques used for standard open surgical procedures. In our series the endoscopic spinal procedures included biopsy only (n = 1, thoracic discectomy (n = 1), multilevel anterior discectomy and fusion (n = l), corpectomy for decompression (n = 4), decompressions and interbody fusions (n = 10), and internal instrumentations (n = 4). Throughout the operation only one trocar was used for introducing the thoracoscope. There were no intraoperative deaths, and no patients showed neurologic deterioration due to the procedures. We conclude that such a technique makes thoracoscopy-assisted spinal surgery simpler and easier and has proved to be an effective, promising procedure. It does not appear to compromise the therapeutic goals set for the patients. The intraoperative vessel bleeding can be easily controlled, and the number of portals for the procedures can be reduced (on average, three portals are enough). Few endoscopic materials were used with our patients, and thus the total economic cost to the patients was reduced.

Original languageEnglish
Pages (from-to)358-362
Number of pages5
JournalWorld Journal of Surgery
Issue number4
StatePublished - 1997
Externally publishedYes


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