Robotic-Assisted Radical Thymectomy with En-Bloc Resection of Right Upper and Middle Lobe Wedges and Pericardium
Nguyen M. Le, MD, Laurence N. Spier, MD, Richard S. Lazzaro, MD.
Northwell Health - Lenox Hill Hospital, New York, NY, USA.
OBJECTIVE: This video demonstrates a robotic-assisted thymectomy for a thymoma that was adhered to the right upper and middle lobes and pericardium.
METHODS: A 42-year-old female who presented with stabbing chest pain was found to have an anterior mediastinal mass on CT scan. Percutaneous biopsy was consistent with thymoma. Imaging suggested adherence to the right upper and middle lobes, but no definite evidence of invasion. It appeared to be adjacent to the pericardium with no convincing evidence of intrapericardial extension or great vessel invasion. The procedure was approached from the right with the patient supine and mildly rolled to the left. Four ports were used - three for the robot and one access port. A robotic-assisted radical thymectomy with en-bloc resection of the right upper and middle lobe wedges as well as the pericardium was completed without complication.
RESULTS: Final pathology revealed Masaoka Stage IIA, WHO Type B3, R0 completely resected thymoma. The patient was discharged home on POD3. Two-year follow-up has demonstrated no recurrence on imaging.
CONCLUSIONS: Robotic-assisted radical thymectomy with en-bloc resection of surrounding lung parenchyma as well as pericardium is safe and feasible.
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