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Plenary paper
Minimally invasive chest wall stabilization: a novel surgical approach to video-assisted rib plating (VARP)
  1. Jose J Diaz1,2,
  2. Faris K Azar3
  1. 1Acute Care Surgery, University of Maryland Medical Center / R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA
  2. 2Program in Trauma, University of Maryland Shool of Medicine, Baltimore, Maryland, USA
  3. 3Program in Trauma, University of Maryland School of Medicine, Baltimore, Maryland, USA
  1. Correspondence to Dr Jose J Diaz; jose.diaz{at}som.umaryland.edu

Abstract

The current morbidity of rib plating is due to the size of the incision required to perform an open procedure. We describe a minimally invasive laparoscopic approach to rib plating. A cadaver model was used to develop the surgical technique by performing both left and right posterior-lateral rib plating. A small incision was made over the auscultatory triangle. The potential working space is developed under the posterior shoulder girdle and the scapula. A table-based retractor was used to elevate the scapula and the muscles. Two separate ports were placed: one camera port and one working port. In three cadaver models, 12 rib fractures were plated and the surgical technique is described. This novel technique will likely allow for faster recovery and was especially useful in the subscapular space.

Level of evidence II.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/tsaco-2019-000366

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    Footnotes

    • Funding This project received research grant from Acute Innovations, Industry Grant $30 000.00.

    • Competing interests JJD receives honorarium for consulting services from Acute Innovations.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.