When Size Is Not a Limitation: Thoracoscopic Resection of a Large Mediastinal Cyst

There are several surgical techniques to access the mediastinum and thoracic cavity. For the removal of large mediastinal tumors, the most commonly employed methods are midline sternotomy or a lateral thoracotomy. Less frequently, incisions such as the classic clamshell or hemi-clamshell are used. While minimally invasive techniques such as robotic-assisted surgery and video-assisted thoracic surgery (VATS) have gained popularity, they are generally not well-suited for large tumors, particularly those exceeding 5 cm in size (1). Here, the authors present a video of VATS resection of a mediastinal cyst measuring 10 x 5.5 cm on the preoperative computed tomography (CT) scan. The mediastinal cystic mass occupied the superior mediastinum, abutting the superior vena cava, the right brachiocephalic vein, and the arch of aorta. 

References

1. Fang Y, Qin Z. Video-assisted thoracoscopic surgery is safe and reliable for large and invasive primary mediastinal tumors. Wideochir Inne Tech Maloinwazyjne. 2021 Mar;16(1):163-168. doi: 10.5114/wiitm.2020.94528. Epub 2020 Apr 20. PMID: 33786130; PMCID: PMC7991948.

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