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Robotic assisted minimally invasive thymectomy with simultaneous bilateral thoracoscopy and contralateral phrenic
Nicholas R Hess1, Nicholas Baker1, Ryan M Levy1
1Department of Cardiothoracic Surgery, University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Journal of Thoracic Disease
|March 20, 2020
Summary
Robotic assisted minimally invasive thymectomy (RAMIT) with bilateral thoracoscopy offers improved visualization for thymic resection. This technique is feasible and may lead to more complete dissections compared to unilateral approaches.
Area of Science:
- Thoracic surgery
- Minimally invasive surgery
- Robotic surgery
Background:
- Unilateral thoracoscopic approaches for thymectomy and anterior mediastinal mass resection are common.
- These approaches can limit visualization of the contralateral mediastinum and phrenic nerves.
- This limitation may hinder complete phrenic to phrenic dissection.
Purpose of the Study:
- To present the early experience of robotic assisted minimally invasive thymectomy (RAMIT) with simultaneous bilateral thoracoscopy.
- To evaluate the feasibility and outcomes of this technique for improved phrenic nerve visualization.
Main Methods:
- Retrospective review of sequential patients undergoing RAMIT with simultaneous bilateral thoracoscopy from January 2015 to May 2016.
- Institutional Review Board approval obtained; individual patient consent waived.
Main Results:
- Twenty-six patients underwent RAMIT for anterior mediastinal masses, myasthenia gravis, or thymoma.
- Median blood loss was 25 mL and median hospital stay was 3 days.
- 80.8% of patients had an uncomplicated hospital course; one patient had asymptomatic hemidiaphragm palsy.
Conclusions:
- RAMIT with simultaneous bilateral thoracoscopy is a feasible approach for thymectomy and mediastinal mass resection.
- This technique may enhance visualization and facilitate more complete thymic resection.
- Further comparative studies and long-term follow-up are necessary to confirm benefits.
