pericardial effusion / pericardial window

 

 

 

 

 

op name : pericardial window

diagnosis :  심장막 삼출 (pericardial effusion) , pleural effusion with tamponade physilogy

여분의 체액이 심장과 심장을 둘러싸는 심장막 사이에 고여 있는 상태. 

여분의 액체는 심장에 압박을 주고 정상적으로 혈액을 펌프질하는 것을 방해한다

 

<Set>

TS minor set + lung ret 7ea + prn. angio set

 

 

 

<수술 준비물>

trap bottle 2ea

1/0 black silk, 1/0 safil, 2/0 safil, 3/0 safil, steri strip

10 mess

28fr cvd chest tube

drap, 3M, Utility

 

 

 

<수술 과정>

1.approach : Rt ant. mini-thoracotomy (4th ICS)

#10 mess inicison - bovie, metz dissection

ret: army

->self ret ( lung ret )

 

2.pericardial window formation

Plerual space 확인

adhesion, effusion 확인

->trap bottle : rubber쪽 andrew suction 연결

*specimen : pleural fluid, pericardial fluid

pericarddium biopsy

 

3.chest tube insertion

black silk 2ea tagging + 28Fr cvd

 

4.wound closer

2/0 safil -> 3/0 safil -> steri strip

 

 

 

 

<reference>

1.google image

2.http://accessemergencymedicine.mhmedical.com/content.aspx?bookid=683§ionid=45343674