Video Assisted Thoracoscopic (VATS) Thymectomy

<p>To view the full text including the Introduction, Patient Selection, Operative Procedure, Preference Card, Tips & Pitfalls, Results, and References, visit <a href="https://www.ctsnet.org/article/video-assisted-thoracoscopic-vats-thymectomy" target="_blank">CTSNet</a>.</p> <p><strong>Figure 1</strong>: Position for right VATS thymectomy.</p> <p><strong>Figure 2</strong>: Right VATS thymectomy incisions.</p> <p><strong>Figure 3</strong>: Camera and port placements.</p> <p><strong>Figure 4</strong>: OR and personnel setup for right VATS thymectomy.</p> <p><strong>Figure 5</strong>: Instrument setup for right VATS thymectomy.</p> <p><strong>Figure 6</strong>: Specimen removed via endobag by enlarging 10mm port incision.</p> <p><strong>Figure 7</strong>: Postoperative incisions and chest tube placement.</p> <p><strong>Figure 8</strong>: Complete anatomical thymus with accessory horn.</p> <p><strong>Figure 9</strong>: Camera and port placements when dissecting thymus gland from contralateral phrenic nerve.</p> <p><strong>Figure 10</strong>: Anatomically complete thymus gland in a myasthenia patient.</p> <p><strong>Figure 11</strong>: Small thymoma.</p> <p><strong>Figure 12</strong>: Small intracapsular and intrathymic thymoma.</p> <p><strong>Figure 13</strong>: Well encapsulated thymoma (5cm).</p> <p><strong>Figure 14</strong>: Well encapsulated large (<5cm) thymoma with intact capsule.</p> <p><strong>Video 1</strong>: Dissection of the thymus into the neck.</p> <p><strong>Video 2</strong>: Delivery of superior and accessory horns from the neck into the mediastinum.</p> <p><strong>Video 3</strong>: Dissection of left lobe of thymus from the opposite phrenic nerve under direct vision.</p> <p><strong>Video 4</strong>: Dissection and division of thymic vessels with ultrasonic harmonic scapel.</p> <p><strong>Video 5</strong>: VATS thymectomy for small thymomas (<2cm).</p> <p><strong>Video 6</strong>: VATS thymectomy for large well encapsulated thymomas.</p> <p><strong>Video 7</strong>: VATS thymectomy for invasive thymomas.</p> <p><strong>Video 8</strong>: Wrong VATS thymectomy technique where the tumor is dissected first.</p> <h3>References</h3> <p>1. Vyas S, Agasthian T, Goh MH, Shankar S. Thoracoscopic thymectomy in a previous sternotomy. <a href="http://aan.sagepub.com/content/14/6/e108.abstract" target="_blank">Asian Cardiovasc Thorac Ann 2006; 14(6):e108-10</a>.</p> <p>2. Soon JL, Agasthian T. Harmonic scalpel in video-assisted thoracoscopic thymic resections. <a href="http://aan.sagepub.com/content/16/5/366.abstract" target="_blank">Asian Cardiovasc Thorac Ann 2008; 16(5):366-9</a>.</p> <p>3. Agasthian T, Lin SJ. Clinical outcomes of VATS for thymomas. Interact Cardio Vasc Thorac Surgery 2008:7: abstract 021, suppl 3 to Vol 7.</p> <p>4. Agasthian T, Lin SJ. Clinical outcome of video-assisted thymectomy for myasthenia gravis and thymoma. <a href="http://aan.sagepub.com/content/18/3/234.abstract" target="_blank">Asian Cardiovasc Thorac Ann 2010; 18(3):234-9</a>.</p> <p>5. Agasthian T. Can invasive thymomas be resected by video assisted thoracoscopic surgery? <a href="http://aan.sagepub.com/content/19/3-4/225.abstract" target="_blank">Asian Cardiovasc Thorac Ann 2011; 19:225-227</a>.</p>