Totally endoscopic subxiphoid pericardioscopy: Early steps with a new surgical tool

Giuseppe Manca, Riccardo Codecasa, Andrea Valeri, Lucio Braconi, Gabriele Giunti, Alessandro Tedone, Avio Maria Perna, Pierluigi Stefàno, Gianfranco Gensini

Research output: Contribution to journalArticlepeer-review


Background: Pericardial pathology still has challenging diagnostic and treating issues. To reduce surgical trauma and pain for the patient, the authors developed a totally endoscopic echo-guided approach for both diagnostic and operative pericardioscopy. Methods: Three steps moved from animal model (8 pigs) through concomitant open-chest interventions (7 patients) to closed-chest interventions for 10 patients with a diagnosis of severe pericardial effusion. Results: A lesion of the right ventricle in one patient (10%) due to imperfect preoperative pericardial visualization needed sternotomy for repair. All the patients, except the aforementioned one, underwent surgery with local anesthesia or mild sedation. No method-related mortality was reported. Conclusion: The closed-chest nonintrapleural approach to the pericardium may represent an evolution, with a positive impact on the treatment of this pathology. Therapeutic maneuvers with rigid instruments in nonintubated patients are possible. Accurate patient selection and technical refinement should increase the safety and effectiveness of the method.

Original languageEnglish
Pages (from-to)444-446
Number of pages3
JournalSurgical Endoscopy and Other Interventional Techniques
Issue number2
Publication statusPublished - Feb 2009


  • Endoscopic procedures
  • Pericardium
  • Surgical instruments

ASJC Scopus subject areas

  • Surgery


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