Awake Endoscopic Thymectomy via an Infrasternal Approach Using Sternal Lifting

Abstract

Recently, thoracic epidural anesthesia (TEA) has been employed to perform awake thoracic surgery procedures. This is the first report that describes an awake endoscopic thymectomy through an infrasternal approach using sternal lifting. This procedure allows the patient to eat, drink, and walk on the day of surgery. TEA can also be used for postoperative analgesia. Our experiences have shown that it is safe and beneficial to apply this procedure.

Key words

awake thoracic surgery - thoracic epidural anesthesia - thymectomy - endoscopic procedure - infrasternal approach - device

References

• 1 Mineo T C. Epidural anesthesia in awake thoracic surgery.  Eur J Cardiothorac Surg. 2007;  32 13-19
• 2 Sakamaki Y, Kido T, Yasukawa M. Alternative choices of total and partial thymectomy in video-assisted resection of noninvasive thymomas.  Surg Endosc. 2007;  2007;  DOI: 10.1007/S00464-007-9606-0
• 3 Kido T, Hazama K, Inoue Y. et al . Resection of anterior mediastinal masses through an infrasternal approach.  Ann Thorac Surg. 1999;  67 263-265
• 4 Tsunezuka Y, Oda M, Matsumoto I. et al . Extended thymectomy in patients with myasthenia gravis with high thoracic epidural anesthesia alone.  World J Surg. 2004;  28 962-965
• 5 Karagoz H Y, Kurtoglu M, Bakkaloglu B. et al . Coronary artery bypass grafting in the awake patient: three years' experience in 137 patients.  J Thorac Cardiovasc Surg. 2003;  125 1401-1404