Video. Natural orifice transtracheal evaluation of the thoracic cavity and mediastinum

This study aimed to determine the feasibility of a novel transtracheal endoscopic technique for thoracic and mediastinum evaluation in a canine model. In two dogs under general anesthesia, a transverse incision was made in the right lateral wall of the lower trachea and used as an entrance for thoracic and mediastinum evaluation. Transtracheal thoracoscopic evaluation was possible in both animals. One animal experienced massive subcutaneous emphysema immediately after evaluation of the thoracic cavity and required chest tube drainage. The follow-up endoscopies 2 weeks after surgery showed good healing of the tracheal openings in both animals. The transtracheal approach to the thoracic cavity and mediastinum appears to be feasible. This technique may provide an intriguing platform for the development of natural orifice transluminal surgery (NOTES) in the thoracic cavity.