Minimally invasive surgical procedures have been at the forefront of the medical field by improving patient outcomes. One such procedure is video-assisted thoracoscopic surgery (VATS), which has largely superseded sternotomies and thoracotomies as a means to access the thoracic cavity space. VATS has proven to decrease postoperative pain by avoiding aggressive muscle splitting of the serratus anterior muscle, forcible rib spreading and fracturing, and costochondral dislocation (Gen Thorac Cardiovasc Surg 2018;66:81-90). However, this is not without limitations. Any surgical procedure within the thoracic cavity comes with the risk of compression or injury to mediastinal structures. This can be seen with something as benign as insufflation of the thorax during VATS. One complication seen in pulmonary procedures is the development of acute intraoperative dysrhythmias, which are further complicated by inability to properly place transcutaneous pacer pads secondary to trocar placement, thus potentially altering management.
We briefly present the case...
