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Clamshell incision approach for giant teratoma
Insights
The clamshell incision, a rare surgical approach, was used to remove a giant mediastinal teratoma. This video demonstrates the clamshell approach for large mediastinal masses when other methods are insufficient.
Area of Science:
- Cardiothoracic Surgery
- Surgical Oncology
- Thoracic Surgery
Background:
- The clamshell incision, a historical transsternal approach, was largely replaced by median sternotomy.
- It remains relevant for specific indications like cardiothoracic trauma and double lung transplants.
- This approach is rarely utilized for large mediastinal tumors requiring complete resection.
Abstract:
The clamshell incision (also known as a transverse or crossbow transsternal incision) was the common approach to the heart in the early days of cardiac surgery and was occasionally also used to access mediastinal tumors or both lungs. However, with the introduction of the median sternotomy, the clamshell incision was virtually forgotten, except for cardiothoracic trauma and double lung transplant. However, in rare situations, such as in large space-occupying lesions in the mediastinum, surgeons will resort to the clamshell approach to achieve exposure and complete resection. In this video tutorial, we demonstrate the operative steps for using the clamshell approach in one of those rare clinical scenarios. The resected mass was a giant mediastinal teratoma measuring 21 x 27 x 6 cm.
