Pulmonary Aspergilloma Operated By Minimally Invasive Surgery.

In patients with pulmonary aspergilloma, surgical resection is generally performed by a thoracotomy because of severe adhesions and the risk for massive hemorrhage. However, because the preoperative general condition is unsatisfactory in many patients, minimally invasive surgery with a smaller incision is considered advantageous. Medical management of pulmonary aspergilloma is difficult. Surgery is a valid indication because unresolved cases may result in hemoptysis. Pulmonary resection, which is most likely to result in a complete cure, is the first-choice surgical procedure. An aspergilloma is a fungus ball (mycetoma) that develops in a preexisting cavity in the lung parenchyma. Underlying causes of the cavitary disease may include treated tuberculosis or other necrotizing infection, sarcoidosis, CF, and emphysematous bullae. The ball of fungus may move within the cavity but does not invade the cavity wall; however, it may cause hemoptysis.
We present a video showing a huge Aspergilloma. The surgery was necessary and the patient was operated by uniportal VATS to remove the left lower lobe. At the end of the procedure the incision was enlarged to remove the specimen. Video by Diego Gonzalez-Rivas, MD.