J Chest Surg.  2024 Jan;57(1):92-95. 10.5090/jcs.23.058.

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

Affiliations
  • 1Department of Thoracic and Cardiovascular Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea

Abstract

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-yearold 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.

Keyword

Mediastinal neoplasms; Needle aspiration; Suture techniques; Robotic surgical procedure; Schwannoma; Case report
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