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The SAGES Manual of Pediatric Minimally Invasive Surgery pp 83–96Cite as

Thoracoscopic Ligation of the Patent Ductus Arteriosus

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Abstract

Patent ductus arteriosus (PDA) ligation is a standard treatment method in infants and children who cannot achieve closure by medical methods. The technical aspects of PDA ligation have continued to evolve since its first description by Dr. Robert Gross at Boston Children’s in 1938. The application of minimally invasive techniques in the form of video-assisted thoracoscopic surgery (VATS) for the management of PDA is now feasible even in the smallest of infants.

Our experience has progressed, and thoracoscopic PDA ligation (T-PDA) is now a standard approach at selected institutions. Utilizing a novel retractor, T-PDA is effective and can be safely performed in infants as small as 500 g. Exposure and magnification of important anatomic landmarks are superior compared to open techniques. This factor may result in shorter operative times which may prove to be significant in these critically ill, very low-birth-weight infants.

T-PDA is a feasible and safe alternative to open PDA ligation and offers potential advantages compared with open thoracotomy, including decreased operative time, reduced postoperative pain, shorter hospital stay, decreased incidence of chest wall deformity, and improved cosmesis.

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Authors and Affiliations

  1. Department of Surgery, Johns Hopkins Hospital, 3207 O’Donnell Street, Baltimore, MD, 21224, USA

    Laura Y. Martin

  2. Department of Surgery, Division of Pediatric Surgery, Johns Hopkins University, 1800 Orleans Street, Baltimore, MD, 21287, USA

    Jeffrey Lukish

Authors
  1. Laura Y. Martin
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  2. Jeffrey Lukish
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Corresponding author

Correspondence to Jeffrey Lukish .

Editor information

Editors and Affiliations

  1. Division of Pediatric Surgery, East Carolina University Brody School of Medicine, Greenville, North Carolina, USA

    Danielle S. Walsh

  2. Northeast Ohio Medical College Division of Pediatric Surgery, Akron Children’s Hospital, Akron, Ohio, USA

    Todd A. Ponsky

  3. Division of Pediatric Surgery, Akron Children’s Hospital, Akron, Ohio, USA

    Nicholas E. Bruns

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© 2017 Springer International Publishing Switzerland

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Martin, L.Y., Lukish, J. (2017). Thoracoscopic Ligation of the Patent Ductus Arteriosus. In: Walsh, D., Ponsky, T., Bruns, N. (eds) The SAGES Manual of Pediatric Minimally Invasive Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-43642-5_7

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  • DOI: https://doi.org/10.1007/978-3-319-43642-5_7

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43640-1

  • Online ISBN: 978-3-319-43642-5

  • eBook Packages: MedicineMedicine (R0)

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