[Single-incision thoracoscopic surgery( SITS) for mediastinal disease]

The use of single-incision laparoscopic surgery is spreading widely, even in Japan, however, in the field of thoracic surgery, there exist no previous reports on the use of the Wound retractor system in single-incision thoracoscopic surgery (SITS) for mediastinal disease. We herein describe the 1st cases of video-assisted SITS of the mediastinum. Fifteen patients (5 males, 10 females) with mediastinal disease underwent SITS. The average age of the patients was 66.8( 44 ~ 90) years. The mean operative time was 186.2 minutes. Chest drainage tubes were not placed in 12 cases. Chest tubes were removed after 2.5 days in three cases. The mean postoperative hospital stay was 3.3 (2 ~ 8) days. In this report, the use of an access instrument for SITS is presented. We performed extended thymectomy using Vein harvest during surgery in patients with myasthenia gravis. The device could be handled successfully, thereby avoiding interferences between the operator and assistants. In conclusion, we believe that SITS is a feasible and safe procedure that is beneficial in selected cases.