Robot-Assisted Thoracoscopic Resection of Anterior Mediastinal Teratoma

Abstract

Introduction:

An 18-year-old girl presented with a moderate-sized anterior mediastinal mass. Percutaneous biopsy suggested a mature cystic teratoma. As this lesion required resection, discussion as to best approach was made. A robot-assisted video-assisted thoracic surgical approach was chosen.

Materials and Methods:

She was placed with her right side up and four ports were used: 12 mm for steri-optic scope, 2–8 mm for robotic instruments, and one 5 mm for assistant. Dissection was performed using the robotic hook cautery. Ligasure was used for hemostasis. Areas of the most adherence were to the pericardium inferiorly, thymus superiorly, and to the intercostal vein and azygos vein. After resection, the teratoma was placed into a 15-mm bag and removed via the inferior most port.

Results and Conclusions:

The operative time was a total of 2.5 hours. She was discharged after the second postoperative day. The tumor was 213 g and measured 10.8×8.2×4.5 cm. Histopathology confirmed mature teratoma arising from thymic tissue with clear margins. She is tumor free at 3 years after surgery. In conclusion, this case demonstrated the advantages of a robotic approach consisting of better depth perception and better range of motion in the chest cavity while still allowing adherence to oncologic principles of complete resection and preservation of function.

No competing financial interests exist.

Runtime of video: 5 mins