Left-hand-dominant subxiphoid thoracoscopic thymectomy: a case series

Area of Science:

• Thoracic Surgery
• Surgical Ergonomics
• Minimally Invasive Procedures

Background:

• Conventional surgical environments pose ergonomic challenges for left-handed surgeons.
• A standardized left-dominant protocol for subxiphoid thoracoscopic thymectomy is proposed.
• This approach integrates perspectives from a left-handed surgeon and surgical educator.

Purpose of the Study:

• To evaluate the feasibility, safety, and reproducibility of a left-dominant subxiphoid thoracoscopic thymectomy protocol.
• To address ergonomic challenges faced by left-handed surgeons in thoracic procedures.
• To establish a standardized framework for ambidextrous skill development in thymectomy.

Main Methods:

• A case series of 82 consecutive thymic mass resections using a left-dominant subxiphoid thoracoscopic approach.
• Procedures were performed at Dalian Medical University.
• Data from patient demographics, tumor characteristics, and surgical outcomes were analyzed.

Main Results:

• Analysis of 82 patients (35 males, 47 females) with a mean age of 53.3 years.
• Histopathological analysis revealed thymomas, thymic carcinomas, and other types, with mean tumor size of 4.0 cm.
• All cases achieved R0 resection, with 98.8% experiencing smooth recovery and no conversion to open thoracotomy.

Conclusions:

• The left-dominant subxiphoid thoracoscopic approach is feasible, safe, and reproducible for thymic mass resections.
• This methodology provides distinct ergonomic advantages for left-handed surgeons.
• The protocol supports ambidextrous skill development and is compatible with right-handed techniques.