Mori Shohei, Shibazaki Takamasa, Kato Daiki, Nakada Takeo, Yabe Mitsuo, Ohtsuka Takashi
Division of Thoracic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
Ann Thorac Surg Short Rep. 2022 Aug 7;1(1):161-163. doi: 10.1016/j.atssr.2022.07.003. eCollection 2023 Mar.
Robot-assisted thymothymectomy with 1 subxiphoid and 3 intercostal ports provides high maneuverability around the upper poles of the thymus and excellent visualization of the superior sections of the phrenic nerves. However, it limits the visibility of the inferior sections of the phrenic nerves and hinders maneuverability around the pericardiophrenic angle in cases of extended thymothymectomy. This report describes the "lateral view preceding method" that successfully uses bilateral thoracoscopy to dissect the lower poles of the thymus and mediastinal fat around the pericardiophrenic angle, followed by robot-assisted thymothymectomy to remove the upper poles of the thymus.
采用1个剑突下端口和3个肋间端口的机器人辅助胸腺切除术，在胸腺上极周围具有较高的可操作性，对膈神经上段有极佳的视野。然而，在扩大胸腺切除术的情况下，它限制了膈神经下段的视野，并妨碍了在心包膈角周围的可操作性。本报告描述了“侧视先行法”，该方法成功地使用双侧胸腔镜解剖胸腺下极和心包膈角周围的纵隔脂肪，随后进行机器人辅助胸腺切除术以切除胸腺上极。
