Laparoscopic pericardial window.

The creation of a drainage orifice in the pericardium for the release of an accumulated effusion has been proven to be an effective means to eliminate the physiologic effects of a cardiac tamponade. Numerous surgical approaches have been used to create an opening in the pericardium for this purpose. Thoracic and thoracoscopic approaches have been found to produce a fair amount of morbidity by further compromising an already compromised cardiopulmonary system by necessitating an invasion into the hemithorax and the requirement of a thoracostomy tube. This report identifies a laparoscopic technique for the creation of a pericardial window with low morbidity that has been successfully used in 14 patients who presented to the Department of Surgery of the Rapid City Medical Center with clinical evidence of pericardial effusion and tamponade.