The Thoracic Surgery Service at Parc Taulí has perfected the subxiphoid approach, incorporating the Da Vinci robot into the technique, for the surgical treatment of pathologies of the thymic gland, which is located in the anterior mediastinum (area located between the lungs, in front of the heart). The two main indications for the removal of this gland are tumors, thymomas, and resection as part of the treatment of myasthenia gravis (autoimmune disease that alters communication between nerves and muscles, producing muscle weakness).
With this new technique, a completely robotic approach is performed, adding to the small subxiphoid incision, one or two small subcostal incisions to introduce 3 robotic arms, and thus reach the thoracic area through the abdomen, without having to enter the thorax directly.
This new approach, which has been perfected by Dr. David Sánchez Lorente, provides the surgeon with a complete view of the thorax, equal to or better than in open surgery such as sternotomy.
The most commonly used minimally invasive techniques today (videothoracoscopy and conventional thoracic robotics) only address one of the two sides of the thorax, which means that the radicality of surgery with these techniques is not as good as when open surgery is performed.
"With our refinement, we can have the same vision and radicality as when we do open surgery. Adding the robot to the subxiphoid approach allows us to do more complex surgeries, larger tumors and facilitate this complex surgery.", explained Dr. Sanchez Lorente
The new approach also ensures that the patient has less pain during the postoperative period, as it does not damage the nerves that pass between the ribs; they can go home 24-48 hours after the operation, and there are aesthetic improvements, because the scars are minimal and outside the chest.
The Thoracic Surgery Service at Parc Taulí put this new technique into operation last June and since then 6 cases have been performed, with excellent results.
Patients have also given very positive feedback on the postoperative results of this new technique. Diana is a 19-year-old girl diagnosed with myasthenia gravis. Last October she underwent surgery by Dr. Sánchez Lorente and within 10 days she was able to live the same life as before the operation and take her university exams.
Dr. David Sánchez Lorente presented the results of the new technique last November at the VI International Thoracic Surgery Meeting in Barcelona, one of the most important congresses worldwide in the field of thoracic surgery, which brings together prestigious surgeons from all over the world. We can say that the presentation of the new technique aroused the interest of many attendees and received congratulations from surgeons of great international reputation.
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