THYMOTHYMECTOMY FOR TUMORS AND CYSTS OF THE LEFT HALF OF THE THYMUS BY RIGHT-SIDED THORACOSCOPIC ACCESS Russian patent published in 2023 - IPC A61B17/94 

FIELD: medicine, cardiology.

SUBSTANCE: thoracoscopic access is performed in the eighth intercostal space along the posterior axillary line, in the fourth intercostal space along the anterior axillary and middle axillary lines in the position of the patient on the left side with the torso tilted 45° towards the back. After the introduction of the thoracoscope and instruments into the right pleural cavity, the right half of the thymus is mobilized with the intersection of the right thymic vein. Then, over the pericardium, the left pleural cavity under the sternum is opened from the lower third of the body of the sternum to the handle. Next, the mobilization of the left half of the thymus along with the tumor or cyst is performed. Tissue dissection is performed in the cranial direction. At the same time, the left half of the gland is mobilized to the level of the brachiocephalic trunks, controlling the vessels of the upper mediastinum. The left thymic vein is crossed. The ascending part of the aorta, the superior vena cava along the medial surface, and the pericardium are exposed. At the same time, the phrenic nerves are visually controlled. The thymus gland is separated from the tissues of the neck and a macropreparation, a tumor or a cyst as a single block with the thymus gland through an access extended to 3–5 cm in the eighth intercostal space is removed.

EFFECT: method makes it possible to exclude median sternotomy, reduce the number of stages of the operation, reduce its traumatism, minimize the probability of postoperative complications, speed up the process of mobilization and rehabilitation of patients, and shorten the period of hospitalization.

1 cl, 1 ex