Management of a Large Hypervascular Apicoposterior Mediastinal Mass Using the Purse-String Suture Technique in Robotic-Assisted Thoracoscopic Surgery: A Case Report

• Published in: Journal of chest surgery Vol. 57; no. 1; pp. 92 - 95
• Main Authors: Kim, Juan, Lee, Jonggeun, Ahn, Hyo Yeong
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society for Thoracic and Cardiovascular Surgery 01.01.2024; Korean Society for Thoracic & Cardiovascular Surgery; 대한심장혈관흉부외과학회
• Subjects: Case Report; mediastinal neoplasms; needle aspiration; robotic surgical procedure; schwannoma; suture techniques; 흉부외과학; Needle aspiration; Case report; Mediastinal neoplasms; Suture techniques; Robotic surgical procedure; Schwannoma
• ISSN: 2765-1606; 2765-1614
• DOI: 10.5090/jcs.23.058

Complete resection of an apicoposterior mediastinal mass is essential due to the mass effect, which exerts pressure on adjacent organs. Recently, the use of minimally invasive surgery has had many advantages. In this report, we describe a case in which a large apicoposterior mediastinal hypervascular mass was managed using a purse-string suture technique during robotic-assisted thoracoscopic surgery (RATS). The patient, a 77-year-old woman, was diagnosed with a 6.2-cm apicoposterior mediastinal hypervascular solid mass originating from the branches of the right subclavian artery. The patient underwent RATS for treatment. To obtain an adequate view of the apex of the thoracic cavity, a needle aspiration was performed, followed by the application of a purse-string suture technique. This was done to reduce the size of the tumor and to prevent catastrophic events such as seeding or spillage of the cystic mass. The mass was histopathologically diagnosed as a schwannoma. The patient was discharged on the first postoperative day without experiencing any complications.