Thoracic Surgery Department, Curie-Montsouris Thorax Institute, Institut Mutualiste Montsouris, Paris, France School of Thoracic Surgery, University of Milan, Milan, Italy.
Thoracic Surgery Department, Curie-Montsouris Thorax Institute, Institut Mutualiste Montsouris, Paris, France.
Multimed Man Cardiothorac Surg. 2024 Oct 30;2024. doi: 10.1510/mmcts.2024.088.
Robotic-assisted thoracic surgery has emerged as a prominent technique for performing radical thymectomies in patients affected by early-stage thymic tumours. This technique is favoured because of its high ergonomics, superior image quality, enhanced instrument manoeuvrability and exceptional precision. Among the different surgical approaches developed, the unilateral and the bilateral intercostal approaches are the most widely diffused. The subxiphoid approach offers several advantages over these approaches, providing a wide visualization of the entire mediastinum and of both pleural cavities while enabling bilateral dissection through a single bilateral small intercostal incision. It brings an optimal central view of the mediastinum, easy control of both phrenic nerves and enhanced dissection at the level of the superior thymic horns and the left brachiocephalic vein, all while minimizing intercostal trauma. We present a robotic subxiphoid radical thymectomy using the da Vinci Xi platform, illustrated by a case involving a patient with a 5-cm thymoma close to the left phrenic nerve.
机器人辅助胸腔手术已成为一种重要的技术，可用于对早期胸腺瘤患者进行根治性胸腺切除术。这种技术之所以受到青睐，是因为它具有很高的人体工程学效益、卓越的图像质量、增强的器械可操作性和出色的精准性。在开发的不同手术入路中，单侧和双侧肋间入路是最广泛传播的。剑突下入路与这些入路相比具有几个优势，可提供整个纵隔和两个胸膜腔的广泛可视化，同时通过单个双侧小肋间切口实现双侧解剖。它提供了纵隔的最佳中心视图，便于控制左右膈神经，并增强对胸腺上极和左头臂静脉水平的解剖，同时最大限度地减少肋间创伤。我们展示了一种使用达芬奇 Xi 平台的机器人剑突下入路根治性胸腺切除术，通过一例靠近左侧膈神经的 5 厘米胸腺瘤患者的病例进行说明。
