Thoracoscopic Therapy Using The FB
Materials and Methods
A total of 19 cases were treated using an FB. The group consisted of 14 cases where rest and thoracic cavity drainage did not provide sufficient improvement for discharge, 4 patients readmitted due to recurrence after discharge following thoracic drainage, and one case of recurrence and readmission following improvement after rigid thoracoscopic bleb electrocoagulation.
Wfe found that even if we inserted a FB into the thoracic cavity, it was virtually impossible to freely observe the target site, since the tip of the FB is not supported. Therefore, we used the outer irrigation sheath of a hysteroscope (Olympus A-4603; 21.5-cm effective length, 6.7-mm inner diameter, and 7.7-mm outer diameter at the tip and 7.1 mm at the insertion end; abbreviated as sheath hereafter; Fig 1), inserted an FB into the tube, and secured a visual field equal to a flexible thoracoscope. The FB (Olympus BF-1T-10) passed through the outer sheath smoothly and was relatively airtight. The FB protruded from the tip and was freely adjustable. In addition, the high-frequency coagulator (Olympus CD-5P) used during blebal coagulation also can be used as it passes through the FB channel (Fig 2).
Figure 1. Hysteroscopes outer irrigation sheath.
Figure 2. Fiberoptic bronchoscope with hysteroscope outer irrigation sheath. Coagulation electrode is inserted through channel of bronchoscope.