Video-Guided Tube Thoracostomy With Use of an Electrical Nonfiberoptic Endoscope Chih-Hao Chen, MD, Ho Chang, PhD, Shih-Yi Lee, MD, MS, Hung-Chang Liu,

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Video-Guided Tube Thoracostomy With Use of an Electrical Nonfiberoptic Endoscope Chih-Hao Chen, MD, Ho Chang, PhD, Shih-Yi Lee, MD, MS, Hung-Chang Liu, MD, Tzu-Ti Hung, BN, Chao-Hung Chen, MD, Chih-Yin Tai, EdD The Annals of Thoracic Surgery Volume 96, Issue 4, Pages 1450-1454 (October 2013) DOI: 10.1016/j.athoracsur.2013.06.098 Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Basic components of device: a small monitor with a lithium battery inside, and an aluminum stylet with an image sensor and integrated processing chip in the tip. The connection is secured with a seven-pin connector. Current and signals are conducted by the four wires inside the aluminum stylet. The Annals of Thoracic Surgery 2013 96, 1450-1454DOI: (10.1016/j.athoracsur.2013.06.098) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Clear view of incision on the small monitor. (B) Performance of procedure under direct vision enables physician to choose a safe entry route to prevent unnecessary injury. The Annals of Thoracic Surgery 2013 96, 1450-1454DOI: (10.1016/j.athoracsur.2013.06.098) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 (A) Chest roentgenogram before the procedure, showing pleural adhesion. (B) Video-guided tube thoracostomy helps achieve safe placement of the tube. The Annals of Thoracic Surgery 2013 96, 1450-1454DOI: (10.1016/j.athoracsur.2013.06.098) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Patient is comfortably placed in a supine position, slightly tilted to the right. After assembly of the device, the tube is slowly and properly positioned, guided by the front view image of the chest cavity shown on the monitor. The Annals of Thoracic Surgery 2013 96, 1450-1454DOI: (10.1016/j.athoracsur.2013.06.098) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 (A) Diaphragm punctured by a chest tube in the emergency room; photograph taken during thoracoscopic surgical procedure. (B) Laceration of lung by a chest tube, which resulted in profound air leaks. The Annals of Thoracic Surgery 2013 96, 1450-1454DOI: (10.1016/j.athoracsur.2013.06.098) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions