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Trans-subxiphoid robotic thymectomy.

Takashi Suda1, Daisuke Tochii2, Sachiko Tochii2

  • 1Division of Thoracic and Cardiovascular Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, Japan suda@fujita-hu.ac.jp.

Interactive Cardiovascular and Thoracic Surgery
|February 21, 2015
PubMed
Summary

This study introduces a novel robotic thymectomy technique using a trans-subxiphoid approach for anterior mediastinal masses. This minimally invasive method offers improved visualization and phrenic nerve identification.

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Area of Science:

  • Thoracic Surgery
  • Minimally Invasive Surgery
  • Robotic Surgery

Background:

  • Minimally invasive surgery is preferred over median sternotomy for resectable anterior mediastinal masses.
  • Various minimally invasive approaches exist, but novel techniques are continually explored.

Purpose of the Study:

  • To describe a new minimally invasive surgical procedure for thymectomy.
  • To evaluate the feasibility and preliminary outcomes of a trans-subxiphoid robotic thymectomy.

Main Methods:

  • A novel technique combining a subxiphoid camera port with a robotic surgery system (da Vinci) was developed.
  • A 3-cm transverse incision below the xiphoid process allowed insertion of a single-port for CO2 insufflation and camera.
  • Bilateral 1-cm incisions in the sixth intercostal space accommodated robotic arms.
Keywords:
Minimally invasive surgeryRoboticsThoracoscopy/Video assisted thoracic surgeryThymectomy

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Main Results:

  • The procedure was successfully performed in 3 patients.
  • The trans-subxiphoid approach provided excellent visualization of the neck region.
  • Phrenic nerve identification was facilitated, and robotic manipulation allowed precise surgical angles.

Conclusions:

  • Trans-subxiphoid robotic thymectomy is a promising new procedure for anterior mediastinal masses.
  • This technique offers advantages in visualization and surgical precision compared to traditional methods.