Robotic subxiphoid-optical thymectomy

Abstract

Robot-assisted thymectomy through a subxiphoid scopic approach can provide a good surgical view, similar to that of median sternotomy. We originally used the subxiphoid port only for the robotic scope to avoid instrument collision with the assistant device. This approach, robotic subxiphoid-optical thymectomy, is advantageous for the safe and accurate dissection of the bilateral phrenic nerves and the left brachiocephalic vein, which are especially needed in extended thymectomy for patients with myasthenia gravis.

Effect of bilateral low serratus anterior plane block on quality of recovery after trans-subxiphoid robotic thymectomy: Results of a randomized placebo-controlled trial

“…[1][2][3] Among the minimally invasive techniques, the robotic subxiphoid approach is a widely used and promising technique. [4][5][6] The advantages of this technique combining the subxiphoid approach with the da Vinci robotic system are as follows: (Ⅰ) the visual field, comparable to that achievable via sternotomy, can be obtained through the camera scope inserted from the midline camera port; (Ⅱ) the soft tissue in the subxiphoid region, unlike rigid rib structure, which makes it easier to transfer the entire specimen through Ivyspring International Publisher the surgical incision; (Ⅲ) the cosmetic outcome is superior; and (Ⅳ) the surgical robot provides a magnified three-dimensional and high-definition vision, as well as offers a markedly improved ergonomics including articulating endo-wristed instruments and filtration of physiologic hand tremors.…”