Atlas of Major Thoracoscopic Pediatric Lung Resection for Congenital Pulmonary Airway Malformation

1 Introduction.- 2 The timing of the surgery.- 3 Technical considerations - "tips and tricks" and postoperative analgesia.- 4 patient position.- 5 the instrumentation.- 6 position of the trocars.- 7 vascular control-bleeding management.- 8 bronchial control - management of air leaks.- 9 Post-operative management-management of complications.- 10 Follow-up.- 11 Upper right lobectomy.- 12 Average lobectomy.- 13 Lower right lobectomy.- 14 Upper left lobectomy.- 15 Lower left lobectomy.- 16 segment definition.- 17 antegrade dissection and identification of vascular and bronchial structures.- 18 extra lobar sequestrectomy.- 19 intralobar sequestrectomy.

This atlas offers a step-by-step approach to Thoracoscopic surgery for Congenital Pulmonary Malformation (CPAM) in each major lung resection. This technique is still a matter of debate and is used approxmately by 50% of the surgeons in Europe. The apprehension of the thoracoscopic approach is complicated firstly by the small size of the child to whom it is proposed and secondly by the risks of perioperative or postoperative complications. Furthermore, the pulmonary malformations object of this investigation are rare, thus making this technique difficult to learn and reproduce.

The volume - the result of a surgical experience acquired since 2007 in this field - offers a step-by-step approach to the procedure in each major lung resection and is illustrated by numerous intraoperative photos, short video clips and even complete resection videos; tips and tricks are presented to facilitate surgery, to make it reproducible and accessible by all surgeons, whether they are young surgeons in training or experienced surgeons.

This atlas aims to complement and not to replace the direct observation in the operating room, or the procedure learning by the reader. It offers essential guide for practitioners, trainees and thoracoscopic surgeons interested in CPAM.

Arnaud Bonnard is the Pediatric Surgery Department Coordinator at AP-HP, Assistance Publique - Paris Hospitals.