Subxiphoid approach for robotic single-site-assisted thymectomy

Seong Yong Park, Kook NamHan, Jeong In Hong, Hyun Koo Kim, Dae Joon Kim, Young Ho Choi

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)


OBJECTIVES: We previously reported a transthoracic approach using the da Vinci Single-SiteTM platform. This study describes the outcomes of robotic single-site thymectomy via a subxiphoid approach based on our previous experiences. METHODS: This study included patients, who underwent single-site robotic thymectomy via the subxiphoid approach between September 2018 and October 2019. A 3- to 4-cm vertical incision was made over the subxiphoid area, and the Lapsingle port with CO2 gas was introduced. After docking at the single site, a 5-mm curved cannula, 5-mm cardiere grasper and Maryland bipolar forceps or permanent cautery hook was inserted. The single-site robotic platform was used to conduct all surgical procedures except the dissection around the inferior portion of the thymic tissue performed via a thoracoscopic approach through the same incision. RESULTS: Overall, 13 patients, including 2 with myasthenia gravis, were enrolled. The mean duration of the surgery and chest drainage were 167.3 ± 52.8 (range 73-253) min and 2.2 ± 0.9 (range 1-5) days, respectively. All surgeries were successfully completed without conversion to an open surgery, and there were no major post-surgical complications. The diagnoses based on histopathology included thymoma in 10 patients, thymolipoma in 2 patients and atypical carcinoid tumour in 1 patient with free resection margin. CONCLUSIONS: This study demonstrated that robotic single-site-assisted thymectomy via the subxiphoid approach is a safe and technically feasible procedure. Although this initial series comprised relatively simple cases, more advanced and complex procedures can soon be performed with the advent of single-port robotic platform.

Original languageEnglish
Pages (from-to)I34-I38
JournalEuropean Journal of Cardio-thoracic Surgery
Publication statusPublished - 2020 Aug 1


  • Robotic single site
  • Subxiphoid approach
  • Thymectomy

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


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