Hemothorax is second only to rib fractures as the most common complication in patients with chest trauma (1). Hemothorax following valve replacement utilizing a minithoracotomy approach on the opposite side is a rare complication of minimally invasive valve replacement. Retained clot with hemothorax can be evacuated by video-assisted thoracoscopic surgery (VATS), but 26.5% require a second procedure, 5.4% a third procedure, and 20.4% require conversion to a thoracotomy (2). Robot-assisted control of hemorrhage and evacuation of hemothorax may be superior to VATS or thoracotomy due to improved vision and precision.
References
- LoCicero J III. Shield’s General Thoracic Surgery. Vol 2. 8th ed. Alphen aan den Rijn, Netherlands: Wolters Kluwer; 2018:1430-1431.
- DuBose J, Inaba K, Demetriades D, et al. Management of post-traumatic retained hemothorax: a prospective, observational, multicenter AAST study. J Trauma Acute Care Surg. 2012;72(1):11-22.
Dr Jett is a speaker and proctor for Intuitive Surgical, Inc.
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Jett GK. Robot-Assisted Evacuation of Hemothorax. April 2019. doi:10.25373/ctsnet.7940762.
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Rightly stated, the robotic approach is one of many alternative tools in the arsenal of recurrent or persistent pleural drainage due to organized hematoma. Well documented.