Use of the harmonic blade scalpel as a novel technique for thoracoscopic resection of pediatric paraspinal masses in children

Introduction: Data support use of video-assisted thoracoscopic surgery (VATS) for safe and effective resection of paraspinal masses in children. Our aim was to describe outcomes following this operation using a novel technique and to compare its use with that of other established techniques. Subjects and Methods: We performed a retrospective chart review of all children (<18 years old) undergoing thoracoscopic resection of paraspinal masses in 2000-2011. Demographics, operative details, and clinical outcomes were summarized and compared between those undergoing resection using a Harmonic® (Ethicon Endo-Surgery, Blue Ash, OH) blade scalpel (HBS) and those who did not. Results: Sixteen cases were identified (median age, 57.5 months; range, 2-204 months). Six cases (37%) underwent VATS with use of the HBS, and 10 (63%) did not. Demographic and clinical factors were well matched. Median tumor diameter was larger in the HBS group (49.2?cm³ versus 18.7?cm³; P=.07). Operative time was similar between groups (121 versus 138 minutes; P=.25), as was the estimated blood loss (10?mL versus 30?mL; P=.91) and chest tube duration (2.1 versus 1.8 days; P=.78). Three cases of Horner's syndrome developed in the standard resection group, and one complication occurred in the HBS group. Conclusions: The Harmonic blade scalpel can be used as a simple alternative to standard dissection techniques for thoracoscopic resection of paraspinal masses in children.