[Robotic Mediastinal Tumor Surgery Using da Vinci Single-port( SP) Surgical System]

The da Vinci single-port (SP) surgical system is a new system in which a camera and three robotic forceps are inserted into the body through a single small wound for surgical manipulation. This paper outlines the basic techniques and tips for mediastinal tumor surgery using the da Vinci SP, especially the subxiphoid single-port approach. In addition, we will discuss the subcostal approach single-port middle or posterior mediastinal tumor surgery. The subxiphoid approach with the da Vinci SP requires specific tips and precautions, such as avoiding interference between the camera and forceps, forceps and another forceps, forceps and wound margin, and arm and pubic bone or lower extremity, but it is possible to perform thymectomy with good operability and minimal risk. Thymectomy using the da Vinci SP allows for unilateral pleural preservation and surgery that is almost equivalent to an extended thymectomy. Similarly, middle and posterior mediastinal tumor surgery via the subcostal approach with this system requires specific tips and precautions to avoid chylothorax and diaphragmatic hernia, as well as pain management measures such as modified-thoraco-abdominal nerves through perichondrial approach (m-TAPA) block.