Abstract
Patent ductus arteriosus (PDA) ligation is a standard treatment method in infants and children who cannot achieve closure by medical methods. The technical aspects of PDA ligation have continued to evolve since its first description by Dr. Robert Gross at Boston Children’s in 1938. The application of minimally invasive techniques in the form of video-assisted thoracoscopic surgery (VATS) for the management of PDA is now feasible even in the smallest of infants.
Our experience has progressed, and thoracoscopic PDA ligation (T-PDA) is now a standard approach at selected institutions. Utilizing a novel retractor, T-PDA is effective and can be safely performed in infants as small as 500 g. Exposure and magnification of important anatomic landmarks are superior compared to open techniques. This factor may result in shorter operative times which may prove to be significant in these critically ill, very low-birth-weight infants.
T-PDA is a feasible and safe alternative to open PDA ligation and offers potential advantages compared with open thoracotomy, including decreased operative time, reduced postoperative pain, shorter hospital stay, decreased incidence of chest wall deformity, and improved cosmesis.
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Martin, L.Y., Lukish, J. (2017). Thoracoscopic Ligation of the Patent Ductus Arteriosus. In: Walsh, D., Ponsky, T., Bruns, N. (eds) The SAGES Manual of Pediatric Minimally Invasive Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-43642-5_7
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DOI: https://doi.org/10.1007/978-3-319-43642-5_7
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