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A low-cost alternative to atomizer in talc pleurodesis
*For correspondence: atul1970@hotmail.com
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This article was originally published by Wolters Kluwer - Medknow and was migrated to Scientific Scholar after the change of Publisher.
This indigenous method was devised at the department of General Surgery, Dayanand Medical College and Hospital, Ludhiana, India, in 2010 as an alternative to an atomizer for video-assisted thoracoscopic (VATS) talc pleurodesis, which is generally done in cases of recurrent pneumothorax, recurrent and malignant pleural effusion. There are two methods of administering sterilized talc - one in the slurry form which has the disadvantage of uneven and ineffective spread and the other being talc poudrage using an atomizer. The latter is known to have an effective distribution of talc over the parietal and visceral pleural surfaces, but the associated high cost limits its use. A mucous extractor (Figure) is a cheap, simple and easy to use device, which is used for the aspiration of mucous and other secretions to maintain the patency of upper airways. In this innovation, a mucous extractor was used for the conversion of slurry talc to vaporized form by attaching one end of the extractor to CO2 insufflation, which was used for talc pleurodesis in a 24 yr old male† with a large right-sided pneumothorax following a ruptured apical bulla (Video). After failed conservative management, he underwent VATS bullectomy with talc (medical grade, 5 Gm) pleurodesis. Postoperatively, air leak subsided and the lung expanded; the patient was discharged on the third postoperative day after chest tube removal. The patient remained asymptomatic on regular follow up for a period of two years, during which imaging showed no recurrence of pneumothorax.
- A mucous extractor attached to a CO2 insufflator.
Vaporizing talc using a mucous extractor on an insufflator is cheap and effective and can have a vast implication by replacing a much costlier alternative, the atomizer.
Video available at ijmr.org.in.
Conflicts of Interest: None.
