AB056. PS02.20: Left sided VATS + subxiphoid for radical thymectomy

Abstract: Technical difficulties during thymic surgery usually represent conversion to not minimal invasive approaches. In centers where minimal invasive left side approach is established, the tissue removal at the right cardiophrenic angle remains a technical problem to be solved. Also non infiltrative tumors with large sizes required a non-minimal invasive approach for correct dissection and specimen retrieval. We present an alternative approach to try to solve both technical issues adding a subxiphoidal port to the conventional left side minimal invasive one. Special importance was given to a careful dissection of both phrenic nerves, which was easily accomplished, adding a higher radicality at the right cardiophrenic tissue removal. Four patients were operated following such approach in our institution achieving a radical thymectomy in all cases. Tumors larger than 5 cm could be retrieved through the subxiphoid incision. No mortality/morbidity is reported.

Keywords: Subxiphoidal; video assisted thoracic surgery (VATS)