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A 40-year-old woman with generalized myasthenia gravis was scheduled for extended thymectomy. The patient under general anesthesia with double-lumen intubation was placed in the supine position. A sealed 5 mm trocar and 2 sealed 12 mm trocars were inserted through the 3rd, 4th and 5th intercostal space at the both side of the anterior axillary line. Under carbon dioxide insufflations by positive pressure of 7 mmHg, thymus and fat tissue was resected completely. An operation time was 162 minutes, and blood losses during operation were 5 ml. The present method was thought to be safe and useful for conducting extended thymectomy.


Kotaro Mizuno, Tsutomu Tatematsu, Risa Oda, Takeshi Yamada. Video-assisted thoracoscopic extended thymectomy while using the carbon dioxide insufflation]. Kyobu geka. The Japanese journal of thoracic surgery. 2012 Aug;65(9):791-4

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PMID: 22868463

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