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P2.15 - Thymoma/Other Thoracic Malignancies (ID 185)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Thymoma/Other Thoracic Malignancies
- Presentations: 1
- Now Available
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
P2.15-05 - Investigation of the Trans-Subxiphoid Robotic Thymectomy (Now Available) (ID 215)
10:15 - 18:15 | Author(s): Chihiro Furuta
We have performed a thoracoscopic thymectomy with a trans-subxiphoid approach and have reported its usefulness. This time, we performed enlarged thymectomy by the trans-subxiphoid approach with the robotic surgery support system (da Vinci surgical system TM; da Vinci TM) and report its improved surgical technique.Method
The patient was placed in the supine position with 10-15 degree head-up. A 3.5 cm transverse skin incision was typically made 1-2 cm below the lower edge of the xiphoid. Through this incision, the space among the posterior surface of the sternum and bilateral mediastinal pleura was enlarged blindly with a finger. Additional two 8-mm robotic trocars were inserted to the bilateral 6th intercostal space under the guidance of a finger. Carbon dioxide (CO2) was insufflated at a pressure of 8 mmHg to get a working space to resect thymus. The whole thymus was excised for patients with thymic tumor, and simultaneous resection of surrounding adipose tissues was performed for patients with myasthenia gravis. Clinical characteristics and early surgical outcomes of the patients were collected and analyzed retrospectively.Result
From April 2017 until March 2019, Fifteen trans-subxiphoid robotic thymectomy were performed. The average age was 58 years, the average operation time was 238.4 minutes (176 - 452 minutes), the console time was 175.3 minutes (97 -390 minutes), the bleeding volume 13.9 g (2- 75 g), the number of surgical ports were all 3 and the resected specimen weight was 41 g (25 - 58 g). The average drainage period was 1.5 days (1 - 2 days), the postoperative hospital stay was 3.2 days (2 - 5 days), no complications were observed. The final pathologic diagnosis was 10 thymoma, 1 thymic cancer, 2 thymic cyst and 2 thymic hyperplasia.Conclusion
Compared with thoracoscopic thymectomy by the trans-subxiphoid approach, surgery using da Vinci TM has longer operation time and more surgical ports. However, even in the narrow space from the neck to the upper mediastinum, da Vinci TM can stably perform accurate operation. Therefore, with good manipulation, using da Vinci TM surgical system for the trans-subxiphoid thymectomy was suggested that safer thymectomy could be performed without surgeon's stress.
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