Difficult Management of a Double-Lumen Endotracheal Tube and Difficult Ventilation during Robotic Thymectomy with Carbon Dioxide Insufflation
Joint Authors
Sugiyama, Yuki
Kawamata, Mikito
Mitsuzawa, Kunihiro
Yoshiyama, Yuki
Shimizu, Fumiko
Fuseya, Satoshi
Ichino, Takashi
Agatsuma, Hiroyuki
Shiina, Takayuki
Ito, Ken-ichi
Source
Issue
Vol. 2017, Issue 2017 (31 Dec. 2017), pp.1-5, 5 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2017-04-26
Country of Publication
Egypt
No. of Pages
5
Main Subjects
Abstract EN
Robotic surgery with carbon dioxide (CO2) insufflation to the thorax is frequently performed to gain a better operative field of view, although its intraoperative complications have not yet been discussed in detail.
We treated two patients with difficult ventilation caused by distal migration of a double-lumen endotracheal tube (DLT) during robotic thymectomy.
In the first case, migration of the DLT during one-lung ventilation (OLV) occurred after CO2 insufflation to the bilateral thoraxes was started.
Oxygenation rapidly deteriorated because dependent lung expansion was restricted by CO2 insufflation.
In the second case, migration of the DLT during OLV occurred while CO2 insufflation to a unilateral thorax and mediastinum was performed.
In both cases, once migration of the DLT during OLV occurred with CO2 insufflation, readjusting the DLT became very difficult because our manipulation of bronchofiberscopy was prevented by the robot arms located above the patient’s head and because deformation of the trachea/bronchus induced by CO2 insufflation caused a poor image of the bronchofiberscopic view.
Thus, during robotic-assisted thoracoscopic surgery with CO2 insufflation, since there is a potential risk of difficult ventilation with a DLT and since readjustment of the DLT is very difficult, discontinuing CO2 insufflation and switching to double-lung ventilation are needed in such a situation.
American Psychological Association (APA)
Sugiyama, Yuki& Mitsuzawa, Kunihiro& Yoshiyama, Yuki& Shimizu, Fumiko& Fuseya, Satoshi& Ichino, Takashi…[et al.]. 2017. Difficult Management of a Double-Lumen Endotracheal Tube and Difficult Ventilation during Robotic Thymectomy with Carbon Dioxide Insufflation. Case Reports in Surgery،Vol. 2017, no. 2017, pp.1-5.
https://search.emarefa.net/detail/BIM-1150129
Modern Language Association (MLA)
Sugiyama, Yuki…[et al.]. Difficult Management of a Double-Lumen Endotracheal Tube and Difficult Ventilation during Robotic Thymectomy with Carbon Dioxide Insufflation. Case Reports in Surgery No. 2017 (2017), pp.1-5.
https://search.emarefa.net/detail/BIM-1150129
American Medical Association (AMA)
Sugiyama, Yuki& Mitsuzawa, Kunihiro& Yoshiyama, Yuki& Shimizu, Fumiko& Fuseya, Satoshi& Ichino, Takashi…[et al.]. Difficult Management of a Double-Lumen Endotracheal Tube and Difficult Ventilation during Robotic Thymectomy with Carbon Dioxide Insufflation. Case Reports in Surgery. 2017. Vol. 2017, no. 2017, pp.1-5.
https://search.emarefa.net/detail/BIM-1150129
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1150129