Non-Intubated Subxiphoid Multiport VATS Thymectomy
This is a video of a non-intubated subxiphoid multiport VATS thymectomy. The patient was a 40-year-old man who was an asymptomatic chronic smoker. On incidental evaluation, HRCT thorax was suggestive of anterior mediastinal lesions, which on further MRI thorax was confirmed to be cystic and 1.8 x 0.8c m. Awake ventilation anesthesia without muscle relaxant was given under LMA. Tubeless principles were adopted. The patient was placed in a supine position, keeping legs wide apart with the surgeon standing in the center in between the legs and the first assistant to the left of the operating surgeon. Lidocaine block to the vagus nerve and sprays on the pleural cavity were done for adequate anesthesia.
Cui F, Liu J, Li S, Yin W, Xin X, Shao W, et al. Tubeless video-assisted thoracoscopic surgery (VATS) under non-intubated, intravenous anesthesia with spontaneous ventilation and no placement of chest tube postoperatively. J Thorac Dis. 2016;8(8):2226‐2232.