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VATS Excision of Subdiaphragmatic Esophageal Bronchogenic Cyst

Wednesday, December 14, 2016

The authors present the case of a 42-year-old male patient with a chest x-ray that suggested a cyst abutting his left diaphragm. The CT scan suggested a cyst with homogenous radiological density, closely related to the esophagus. A duplication cyst was also suspected. This video describes the steps taken to access the cyst through the diaphragm, and how to repair the diaphragm afterwards. Upper GI endoscopy was integral during the resection to ensure patency of the esophagus. The final histology confirmed the diagnosis of a bronchogenic cyst with no malignant potential.

Bronchogenic cysts are rarely found in the abdomen. They usually present as a mass expanding the crura of the diaphragm, related to the esophago-gastric junction and on or around the stomach, pancreas, adrenal glands, as well as in retrocaecal and retroperitoneal positions. Although most cases are incidentally discovered, the preoperative differential diagnosis often includes tumors with malignant potential and necessitates surgical resection to obtain a definitive diagnosis.


Obviously you can, but in the way I approach the lung, I keep changing the retraction every 2 minutes. This retraction is useful when you want the lung to be out of the way for the duration of the operation. Professor Dominique Gossot has come up with Bulldog clips that can be used for retraction. Have a look at those. Lung retraction still needs bright ideas, and I don't think we have cracked it yet.

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