A distinguished pediatric surgeon with extensive operating room experience, Dr. Gustavo Stringel serves as an attending surgeon at Westchester Medical Center and as surgeon in chief at Maria Fareri Children's Hospital in Valhalla, New York. An expert in thoracoscopy in children, Dr. Gustavo Stringel has published and lectured widely on this topic.

Used by physicians for diagnostic and treatment purposes, video-assisted thoracoscopy employs an endoscope through the chest wall so the clinician can visually examine the chest area, collect tissue samples, or perform surgery. A tubular instrument composed of flexible fiber optics or more rigid materials, the endoscope often has one or more channels through which surgical instruments are passed.

For patients of pediatric age, modern thoracoscopy is frequently used when there are indications of interstitial lung disease, pulmonary tumors, or other conditions. With technological advances and improved anesthetic techniques, thoracoscopy has proved to be a safe, minimally invasive technique for the extraction of blebs, the vesicular outpocketing of a nuclear or plasma membrane. In general, the procedure is useful for a thorough brushing of the pleural cavity.

Similar to minimally invasive diagnostic and surgical procedures for adults, thoracoscopy offers a number of advantages for pediatric patients. Nevertheless, in pediatrics, there are many more hurdles to overcome before minimally invasive approaches become the default standard. Manufacturers have been slow to produce size- and age-appropriate surgical instruments. Furthermore, the smaller size of child patients requires greater precision and skill, and therefore requires more extensive training for surgeons.

 


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