In this video, the authors present the case of a 65-year-old female diagnosed with a central squamous cell carcinoma of the left upper lobe with nodal involvement in stations 5 and 6, initially detected during the evaluation of a persistent cough. Computed tomography revealed a 57 mm centrally located mass in the left upper lobe with involvement…
A gentleman in his 60s with advanced oesophageal cancer (cT4bN1M0) and extensive nodal disease developed a malignant tracheoesophageal fistula (TEF). Due to the presence of the fistula, he was not a candidate for radiotherapy given the high risk of exacerbating the defect. He completed five cycles of 5-fluorouracil (5-FU)-based chemotherapy and was on maintenance pembrolizumab administered every six weeks. Clinically, he…
Introduction Video-assisted thoracoscopic thymectomy (VATS) is an established approach for myasthenia gravis. The authors present a bilateral VATS thymectomy, highlighting key technical aspects. Case Description A 29-year-old male with ptosis was diagnosed with myasthenia gravis. Positron emission tomography (PET) imaging showed a 2 × 2 cm fluorodeoxyglucose (FDG)-avid anterior mediastinal lesion (standardized uptake value [SUV] 4.69). After medical optimization, bilateral VATS thymectomy was performed, starting…
Traumatic tracheobronchial injury is a rare but life-threatening complication of blunt chest trauma, accounting for approximately 0.5-2 percent of cases (1). These injuries most commonly occur near the right main bronchus due to the fixed position of the carina and reduced mediastinal protection (2). Prompt diagnosis and surgical intervention are essential to prevent respiratory failure and long-term complications. This video demonstrates the case…
Advanced-stage lung cancer patients who have undergone lung resection, adjuvant chemotherapy, and immunotherapy are often immunocompromised and prone to pleural space infections. A pleural window is usually not accepted by patients because of poor quality of life. Thoracoplasty with latissimus dorsi myoplasty, on the other hand, continues to play a vital role in selected patients,…
Background Transcatheter aortic valve replacement (TAVR) is now widely used for the management of aortic stenosis. As indications expand to include younger and lower-risk patients, surgical explantation of failed TAVR prostheses is being encountered more frequently. TAVR explantation is technically demanding due to the extensive endothelialization of the device and its integration with the aortic…
This video demonstrates the surgical management of a 36-year-old non-smoking female who was diagnosed with a typical carcinoid tumor involving the left lower lobe bronchus. The diagnosis was established through endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), and further evaluation with computed tomography (CT) and PET-DOTANOC imaging revealed a 25 mm centrally located hilar lesion without…
This video demonstrates a case of Tetralogy of Fallot (TOF), and after clearing the right ventricular outflow tract (RVOT) and closing the ventricular septal defect (VSD) from the right atrium, the focus shifted to the RVOT from the pulmonary artery aspect. An initial incision was made over the pulmonary artery, and the pulmonary valve was…
Position of the Patient The patient was positioned supine on the bed with a footrest. This secures the patient well, especially when a steep reverse Trendelenburg position is required. A steep reverse Trendelenburg position was used to allow the abdominal contents to fall away from the diaphragm. The patient was positioned flush to the right…
The patient was a 20-year-old female referred to the heart center for the evaluation of rheumatic heart disease and severe mitral regurgitation. She reported dyspnea on moderate exertion New York Heart Association (NYHA) Class III, as well as palpitations and reduced exercise tolerance, which progressively worsened over a period of three years. Her rheumatic history…
Case Presentation A 31-year-old female presented with recurrent pneumonias and progressive shortness of breath attributed to suspected congenital lobar emphysema of the left upper lobe. She was initially evaluated by interventional pulmonology for possible endobronchial valve placement; however, this approach was deferred due to concerns about left upper lobe bronchial atresia. Thoracic surgery was subsequently…
This video demonstrates the key surgical steps of transdiaphragmatic aorto-supra-celiac aortic extra-anatomic bypass. The case involved a 16-year-old boy who presented with shortness of breath on exertion. Echocardiography revealed type A interrupted aortic arch (IAA) with multiple collaterals draining into the distal part of the descending thoracic aorta (DTA), generalized wall hypokinesia, and an ejection…
Case Presentation A 55-year-old female was evaluated for a large, asymptomatic Morgagni hernia containing the transverse colon and a significant portion of the greater omentum that had been incidentally noted on imaging. Preoperative imaging demonstrated a sizable anterior diaphragmatic defect measuring approximately 30 cm². Elective operative repair of this hernia was chosen. Given the size…
This video presents the case of a 67-year-old man with situs inversus totalis who underwent a robotic-assisted right upper lobe segmentectomy, specifically a culminectomy, for the treatment of lung cancer. The patient had a significant oncological history, having previously been treated in 2014 for a pulmonary squamous cell carcinoma (pT1bN1) with a left middle lobectomy…
Pulmonary mucoepidermoid carcinoma (PMEC) is a rare salivary-gland–type endobronchial malignancy in children and may present with recurrent unilateral infections despite a deceptively subtle chest radiograph. The authors present an educational case of an adolescent male with months of febrile respiratory episodes treated as pneumonia, including hypoxemia requiring oxygen and repeated hospital admissions. Subsequent bronchoscopy demonstrated…
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…
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