| Autor: |
Mahmoud Ismail, Ralph-Ingo Rückert, Jens C. Rückert, Marc Swierzy |
| Rok vydání: |
2018 |
| Předmět: |
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| Zdroj: |
Atlas of Robotic Thoracic Surgery ISBN: 9783319645063 |
| DOI: |
10.1007/978-3-319-64508-7_6 |
| Popis: |
Thymectomy is necessary for thymic tumors and an essential part of the therapeutic strategy for myasthenia gravis. Within a century, the history of thymectomy has been characterized by the development of minimally-invasive surgical techniques. The latest refinement is robotic-assisted thymectomy. The perioperative management including anesthesia is described. The stepwise operative technique starts with special positioning of the patient. The preferred conduct of the operation is provided. For anatomical reasons the left side is preferred for the unilateral approach. The extended thymectomy is necessary to achieve the best outcome. This includes resection of the contralateral cardiophrenic tissue. Tips for performing the operation are included and pitfalls are described. All essential steps of the operation are illustrated. The advantages of robotic technology optimized by the described approach and consist of surgeon-directed 3-D vision, magnification, multiple arcs of instrument movement, tremorless precision, and potentially the most thorough mediastinal dissection of all minimally invasive surgical options. The review of the supportive literature for thymectomy in the treatment of myasthenia gravis is described; especially the recently published prospective randomized trial comparing medical therapy to thymectomy, showing superiority of thymectomy. It is likely that the impact will increase the number of patients seeking thymectomy. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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