A new retractor system for thoracoscopic thymectomy using the anterior chest wall-lifting method

Clinical Application of Thoracoscopic Resection of Anterior Mediastinal Tumors under the Xiphoid Process

Objective

To explore the feasibility and advantages of thoracoscopic resection of anterior mediastinal tumors through subxiphoid and lateral thoracic approaches.

Method

74 patients with anterior mediastinal tumors hospitalized in our hospital from January 2019 to January 2022 were retrospectively analyzed. They were divided into the lateral chest group (31 cases) and the infraxiphoid group (43 cases) according to different operation methods. The tumor size, operation time, intraoperative bleeding, postoperative pain score, postoperative complications, postoperative drainage tube removal time, and hospital stay were compared between the two groups.

Result

The intraoperative bleeding and postoperative pain scores in the subxiphoid group were better than those in the lateral chest group. There was no significant difference in operation time and postoperative complications between the two groups.

Conclusion

Compared with the lateral thoracic approach, the thoracoscopic subxiphoid approach can be more safe and effective in resectioning anterior mediastinal tumors.

Thoracoscopic robot-assisted extended thymectomy in the human cadaver

METHODS

Thoracoscopic robot-assisted extended thymectomy was performed in a human cadaver. The technique utilized the da Vinci surgical system inserted through the subxiphoid approach with the sternum lifted upward (anteriorly). A small subxiphoid incision and two additional thoracoports were made in the chest wall, and the sternum was lifted by a new lifting retractor system.

RESULTS

This method provided sufficient view and working space in the anterior mediastinum. A complete thymectomy was performed with facility. The robotic system provides superior optics and allows for enhanced dexterity.

CONCLUSIONS

Minimally invasive robotic-assisted thymectomy is an effective procedure and may add benefits for both surgeon and patients.

Thoracoscopic robot-assisted extended thymectomy in human cadaver

Thoracoscopic robot-assisted extended thymectomy was performed in a human cadaver. The technique utilized the da Vinci surgical system inserted through the subxiphoid approach with the sternum lifted upward (anteriorly). A small subxiphoid incision and two additional thoracoports were made in the chest wall, and the sternum was lifted by a new lifting retractor system. This method provided sufficient view and working space in the anterior mediastinum. Complete thymectomy was performed with facility. The robotic system provides superior optics and allows for enhanced dexterity. Minimally invasive robotic-assisted thymectomy is an effective procedure and may add benefits for both surgeon and patients.