Subxiphoid Mediastinal Resections

We previously developed a surgical technique called subxiphoid single-port thymectomy to excise the thymus through a single opening made below the xiphoid process. This procedure is facilitated by creating adequate space for surgery by inducing compression of bilateral lungs and the mediastinum by means of CO₂ insufflation. We previously reported a comparative study of the early outcomes after VATS thymectomy and single-port thymectomy performed at our hospital from January 2005 to December 2014. Subxiphoid single-port thymectomy takes the same amount of operative time as VATS thymectomy via a lateral thoracic approach, but results in less blood loss and enables earlier termination of postoperative analgesics. This method offers an excellent cosmetic outcome with just one 3-cm incision in the abdomen and is the most minimally invasive form of thymectomy that avoids sternotomy and intercostal nerve injury. Investigation of the safety of this procedure and long-term therapeutic outcomes for myasthenia gravis and anterior mediastinal tumors is necessary.