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Uniportal Subxiphoid Thymectomy

Monday, December 14, 2015

This video demonstrates an extended thymectomy through a subxiphoid port in a 51-year-old female patient, who presented with a 2.5 cm thymoma and myasthenia gravis. A 3.5 cm incision was made below the xiphoid process through the linea-alba. A single incision laparoscopic surgery trocar was inserted, and CO2 was insufflated. The dissection was completed under visual guidance through a 10 mm variable angle telescope with bending tip grasping forceps, an ultrasonic dissection device, and a hook cautery. Bilateral phrenic nerves, mammary arteries and veins, and the cranial part of the mediastinum were always under optimal control during the dissection. This permitted a safe en bloc dissection of the thymus, thymic tumor, and surrounding fatty tissue anterior to the phrenic nerves. No complications occurred during or after the operation. The drain was taken out after one day, and the patient was discharged home two days after surgery.

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