Videothoracoscopic excision of mediastinal tumors and cysts using the harmonic scalpel

Thorac Cardiovasc Surg. 2008 Aug;56(5):278-82. doi: 10.1055/s-2008-1038630.


Objective: The aim of this study was to evaluate the safety and reliability of the harmonic scalpel for performing VATS excisions of mediastinal tumors and cysts.

Methods: We have prospectively studied 19 cases presenting with a mediastinal tumor or cyst operated on consecutively since January 2003.

Results: We performed 10 left-sided and 9 right-sided VATS procedures; the mean age at operation was 50 +/- 15 years. Two masses were in the anterior mediastinum, 5 in the middle mediastinum and 12 in the posterior mediastinum. One patient required conversion to a minithoracotomy for bleeding. The maximum tumor diameter was 38 +/- 14 mm and the maximum cyst dimension was 55 +/- 20 mm. The mean operating time was 66 +/- 28 min. Three patients experienced minor complications. The postoperative hospital stay was 3.5 +/- 1.7 days, and we had no mortality. Histopathology revealed 1 esophageal leiomyosarcoma, 1 Langerhans cell histiocytosis X, 1 hamartoma, 5 schwannomas, 1 neurofibroma, 1 malignant peripheral nerve sheath tumor, 1 reactive lymphadenopathy, 1 tuberculous lymphadenopathy, 1 cystic hygroma, 2 bronchogenic cysts, 2 foregut cysts, 1 thymic cyst, and 1 pleuropericardial cyst. There has been no recurrence of tumor or cyst on follow-up.

Conclusions: Videothoracoscopic excision of mediastinal tumors and cysts can be safely performed using the harmonic scalpel with a low morbidity and mortality.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Length of Stay
  • Male
  • Mediastinal Cyst / pathology
  • Mediastinal Cyst / surgery*
  • Mediastinal Neoplasms / pathology
  • Mediastinal Neoplasms / surgery*
  • Middle Aged
  • Prospective Studies
  • Surgical Instruments*
  • Thoracic Surgery, Video-Assisted / adverse effects
  • Thoracic Surgery, Video-Assisted / instrumentation*
  • Time Factors
  • Treatment Outcome
  • Young Adult