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  • Title: Video-assisted subxiphoid pericardiectomy.
    Author: Yim AP, Ho JK.
    Journal: J Laparoendosc Surg; 1995 Jun; 5(3):193-8. PubMed ID: 7548995.
    Abstract:
    We report a case of malignant pericardial effusion with chronic tamponade treated by video-assisted subxiphoid pericardiectomy in a 58-year-old female. The procedure was performed under local anesthesia through a 3.5-cm midline incision over the xiphoid process using a mediastinoscope, a 5-mm telescope connected to the video camera, and an endoscopic grasper and scissors. A large piece of pericardium (5 cm x 6 cm) over the right ventricle was excised. The patient obtained immediate relief and was discharged on the second postoperative day. Follow-up at 4 months showed no recurrence of effusion. Video assistance allows generous pericardiectomy, and as the rate of recurrence has been suggested to be directly related to the extent of resection, video-assisted subxiphoid pericardiectomy offers a theoretical advantage over the conventional approach, as more pericardium can be excised. We recommend that this technique receive further investigation.
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