Video-assisted thoracoscopic extrapleural pneumonectomy for malignant pleural mesothelioma

摘要

Although extrapleural pneumonectomy is performed for malignant pleural mesothelioma, it(is one of the most invasive surgical procedures in the field of thoracic surgery. Herein we describe extrapleural pneumonectomy by video-assisted thoracoscopic surgery without rib spreading as a new approach to extrapleural pneumonectomy for malignant pleural mesothelioma.The surgical procedure was performed with the patient in the lateral decubitus position with isolated lung ventilation. The operating table was flexed to expand the intercostal spaces. First, an incision of approximately 12 cm was made laterally along the costal arch (Figure 1). The external oblique muscle and part of the rectus abdominis muscle were incised down to the peritoneum. The peritoneum and diaphragm were separated manually.