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Video Assisted Thoracoscopic (VATS) Thymectomy

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posted on 2022-11-09, 21:55 authored by Thirugnanam Agasthian

To view the full text including the Introduction, Patient Selection, Operative Procedure, Preference Card, Tips & Pitfalls, Results, and References, visit CTSNet.

Figure 1: Position for right VATS thymectomy.

Figure 2: Right VATS thymectomy incisions.

Figure 3: Camera and port placements.

Figure 4: OR and personnel setup for right VATS thymectomy.

Figure 5: Instrument setup for right VATS thymectomy.

Figure 6: Specimen removed via endobag by enlarging 10mm port incision.

Figure 7: Postoperative incisions and chest tube placement.

Figure 8: Complete anatomical thymus with accessory horn.

Figure 9: Camera and port placements when dissecting thymus gland from contralateral phrenic nerve.

Figure 10: Anatomically complete thymus gland in a myasthenia patient.

Figure 11: Small thymoma.

Figure 12: Small intracapsular and intrathymic thymoma.

Figure 13: Well encapsulated thymoma (5cm).

Figure 14: Well encapsulated large (<5cm) thymoma with intact capsule.

Video 1: Dissection of the thymus into the neck.

Video 2: Delivery of superior and accessory horns from the neck into the mediastinum.

Video 3: Dissection of left lobe of thymus from the opposite phrenic nerve under direct vision.

Video 4: Dissection and division of thymic vessels with ultrasonic harmonic scapel.

Video 5: VATS thymectomy for small thymomas (<2cm).

Video 6: VATS thymectomy for large well encapsulated thymomas.

Video 7: VATS thymectomy for invasive thymomas.

Video 8: Wrong VATS thymectomy technique where the tumor is dissected first.

References

1. Vyas S, Agasthian T, Goh MH, Shankar S. Thoracoscopic thymectomy in a previous sternotomy. Asian Cardiovasc Thorac Ann 2006; 14(6):e108-10.

2. Soon JL, Agasthian T. Harmonic scalpel in video-assisted thoracoscopic thymic resections. Asian Cardiovasc Thorac Ann 2008; 16(5):366-9.

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.

4. Agasthian T, Lin SJ. Clinical outcome of video-assisted thymectomy for myasthenia gravis and thymoma. Asian Cardiovasc Thorac Ann 2010; 18(3):234-9.

5. Agasthian T. Can invasive thymomas be resected by video assisted thoracoscopic surgery? Asian Cardiovasc Thorac Ann 2011; 19:225-227.

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