Two-Site Thoracoscopic Surgery for Extra-Pulmonary Sequestration Using an Extraction Wound: Five Pediatric Cases With Favorable Cosmetic Outcomes

Asian J Endosc Surg. 2025 Jan-Dec;18(1):e70005. doi: 10.1111/ases.70005.

Abstract

Many institutions perform thoracoscopic surgery for pediatric extrapulmonary sequestration (EPS). This approach achieves good cosmetic outcomes due to the small skin incision in comparison to open surgery. However, an extension or additional incision is sometimes necessary to extract resected specimens from the thoracic cavity, which reduces the advantages of this procedure. We herein report 5 cases of two-site thoracoscopic surgery (TTS) using an extraction wound with left-sided EPS. In this procedure, a camera port was inserted inside the skin incision at the sixth intercostal space of the middle axillary line using optical methods, and the operator's left-hand port was inserted inside the same skin incision. The EPS was resected and extracted through a skin incision without extension or additional incision. A surgeon-in-training performed the procedure in 4 of the 5 cases. The postoperative course was uneventful in all cases. The patients showed quick recovery and good cosmetic outcomes. TTS is a cosmetically favorable approach for EPS.

Keywords: extra‐pulmonary sequestration; thoracoscopic surgery; two‐site surgery.

Publication types

  • Case Reports

MeSH terms

  • Bronchopulmonary Sequestration / surgery
  • Child
  • Child, Preschool
  • Esthetics
  • Female
  • Humans
  • Infant
  • Male
  • Thoracic Surgery, Video-Assisted / methods
  • Thoracoscopy* / methods
  • Treatment Outcome