Single-Port Thymectomy Through an Infrasternal Approach

Suda, Takashi; Sugimura, Hiroshi; Tochii, Daisuke; Kihara, Mariko; Hattori, Yoshinobu

doi:10.1016/j.athoracsur.2011.08.047

Cited by 104 publications

(72 citation statements)

References 5 publications

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“…Toker et al reported a correlation between the operation time and BMI; however, we did not detect any such correlation in the present study. 18) We also performed single-port thymectomy, which was previously reported by Suda et al 19) Not setting a thoracic port seemed attractive to us, as this would likely reduce the postoperative pain although two-port thymectomy would have likely reduced the postoperative pain compared with the lateral approach. Unfortunately, we did not obtain any data regarding the postoperative pain on a numerical rating scale in the present study.…”

Section: Disclosure Statementmentioning

confidence: 99%

Thoracoscopic Thymectomy Using a Subxiphoid Approach for Anterior Mediastinal Tumors

Numanami

Yano

Yamaji

et al. 2018

ATCS

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Purpose: Video-assisted thoracic surgery (VATS) techniques have been widely used for resection of mediastinal tumors. This study investigated the usefulness of the subxiphoid approach in thoracoscopic thymectomy. Methods: In all, 36 patients with anterior mediastinal tumor underwent thymectomy using the subxiphoid approach in two Japanese institutions. These patients were retrospectively reviewed and analyzed. Results: There were 16 females and 20 males with a mean age of 57 years. Five patients underwent partial thymectomy (PT), 27 underwent total or subtotal thymectomy, and 4 underwent thymectomy with combined resection (CR) of the surrounding organs or tissues. The mean maximum tumor diameter, amount of resected tissue, and blood loss were 4.1 cm, 72.5 g, and 20.6 g, respectively. More than half of tumors were diagnosed as thymoma (n = 19). The operation time was prolonged with a greater volume of thymectomy. The duration of chest tube drainage and postoperative stay were 1.7 ± 1.0 days and 5.9 ± 7.6 days, respectively. Four patients suffered intraoperative and postoperative complications, as follows: bleeding of the innominate vein, bleeding of the internal thoracic vein, crisis of myasthenia gravis (MG), pericarditis, and phrenic nerve paralysis. There were no mortalities after surgery. Conclusion: Subxiphoid thoracoscopic thymectomy might be a safe and useful approach for mediastinal tumors.

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Section: Disclosure Statementmentioning

confidence: 99%

Thoracoscopic Thymectomy Using a Subxiphoid Approach for Anterior Mediastinal Tumors

Numanami

Yano

Yamaji

et al. 2018

ATCS

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“…In recent years, single-port surgery has come to be used in the field of pulmonary surgery (19,20). In contrast to robotic surgery, which aims to allow more advanced surgical technique to be performed with increased accuracy while maintaining the current low levels of invasiveness, singleport surgery aims to be even less invasive than current techniques.…”

Section: Is Robotic Surgery More Useful Than Vats?mentioning

confidence: 99%

Transition from video-assisted thoracic surgery to robotic pulmonary surgery

Suda¹

2017

J. Vis. Surg.

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Abstract:The "da Vinci Surgical System" is a robotic surgical system that utilizes multi-jointed robotic arms and a high-resolution three-dimensional video-monitoring system. We report on the state of transition from video-assisted thoracoscopic surgery (VATS) to robotic pulmonary surgery, the surgical outcomes of robotic surgery compared to VATS, and the future of robotic surgery. Surgery utilizing the da Vinci Surgical System requires a console surgeon and assistant who have been certified by Intuitive Surgical, Inc., the system manufacturer. On the basis of the available medical literature, a robotic lobectomy has a learning curve that extends over approximately 20 cases for a surgeon who has mastered VATS. Surgery using the da Vinci System is safe, is associated with lower morbidity and mortality rates than thoracotomy, leads to shorter postoperative hospital stays, and ensures improved postoperative quality of life. Currently, no prospective studies comparing it to VATS have been conducted. The various studies that have compared robotic surgery and VATS have reported different results. At the present time, the benefits to patients of robotic surgery compared to VATS remain unclear. Areas in which robotic surgery may be superior to VATS include the superior operability of robotic surgery that improves safety and decreases the incidence of complication. To show that the costly robotic surgery is superior to VATS, prospective multicenter randomized studies need to be conducted. The da Vinci robot-assisted surgical system has already been highly evaluated for its safety, with recent studies reporting satisfactory outcomes. It remains necessary to verify whether the benefits to patients justify the higher cost of robotic surgery. Future developments in the field of robotic engineering will likely lead to the creation of systems that are even less invasive and allow for more advanced surgical techniques.

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“…Finally, the totally freed thymic gland and perithymic fat tissue could be brought out from the subxiphoid incision. En bloc resection of the thymus was performed by wielding a long curved-tip ring forceps in the left hand and a Harmonic scalpel in the right hand (Figures 4,5). A 20F chest tube was inserted into mediastinal cavity through the thoracoscopic port site for drainage for 13 patients, while for the 2 patients lung dilation was applied and no chest tube was placed.…”

Section: Surgical Techniquementioning

confidence: 99%

Subcostal thoracoscopic extended thymectomy for patients with myasthenia gravis

Tang

Ming-yang

et al. 2016

J. Thorac. Dis.

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Background: Extended thymectomy is indicated for patients with myasthenia gravis (MG) when drugresistance or dependence is seen. We have employed a technique for subcostal thoracoscopic extended thymectomy (STET) on patients with MG. Conclusions: This procedure showed satisfactory results for patients with MG. Moreover, the STET approach is more easily for surgeons to fully reveal the bilateral phrenic nerve and the upper thymic poles. We believe that STET is a satisfactory procedure for performing extended thymectomy in well selected patients.

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Single-Port Thymectomy Through an Infrasternal Approach

Cited by 104 publications

References 5 publications

Thoracoscopic Thymectomy Using a Subxiphoid Approach for Anterior Mediastinal Tumors

Thoracoscopic Thymectomy Using a Subxiphoid Approach for Anterior Mediastinal Tumors

Transition from video-assisted thoracic surgery to robotic pulmonary surgery

Subcostal thoracoscopic extended thymectomy for patients with myasthenia gravis

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