Subxiphoid approach for robotic single-site-assisted thymectomy. (15th February 2020)

• Record Type: Journal Article
• Authors: Park, Seong Yong; Han, Kook Nam; Hong, Jeong In; Kim, Hyun Koo; Kim, Dae Joon; Choi, Young Ho
• Is Part Of: European journal of cardio-thoracic surgery. Volume 58(2020)Supplement 1
• Page Start: i34
• Page End: i38
• Publication Date: 2020-02-15
• Subjects: Thymectomy -- Robotic single site -- Subxiphoid approach; Heart -- Surgery -- Periodicals; Chest -- Surgery -- Periodicals; 617.54
• DOI: 10.1093/ejcts/ezaa036
• Languages: English
• ISSNs: 1010-7940

Abstract

Abstract: OBJECTIVES: We previously reported a transthoracic approach using the da Vinci Single-Site™ platform. This study describes the outcomes of robotic single-site thymectomy via a subxiphoid approach based on our previous experiences. METHODS: This study included patients, who underwent single-site robotic thymectomy via the subxiphoid approach between September 2018 and October 2019. A 3- to 4-cm vertical incision was made over the subxiphoid area, and the Lapsingle port with CO2 gas was introduced. After docking at the single site, a 5-mm curved cannula, 5-mm cardiere grasper and Maryland bipolar forceps or permanent cautery hook was inserted. The single-site robotic platform was used to conduct all surgical procedures except the dissection around the inferior portion of the thymic tissue performed via a thoracoscopic approach through the same incision. RESULTS: Overall, 13 patients, including 2 with myasthenia gravis, were enrolled. The mean duration of the surgery and chest drainage were 167.3 ± 52.8 (range 73–253) min and 2.2 ± 0.9 (range 1–5) days, respectively. All surgeries were successfully completed without conversion to an open surgery, and there were no major post-surgical complications. The diagnoses based on histopathology included thymoma in 10 patients, thymolipoma in 2 patients and atypical carcinoid tumour in 1 patient with free resection margin. CONCLUSIONS: This study demonstrated that robotic single-site-assisted thymectomy via the subxiphoid approach is a safe and technically feasible procedure. Although this initial series comprised relatively simple cases, more advanced and complex procedures can soon be performed with the advent of single-port robotic platform.