Video assisted thoracoscopic (VATS) Thymectomy-a better alternative

Background With the introduction of video imaging technique in late 1980s the field of thoracoscopy was expanded into video assisted thoracic surgery (VATS) in 1990. VATS has several unique advantages like reducing repiratory complications, hospital stay and post operative pain due to avoidance of thoracotomy/sternotomy. It is indicated in almost all thoracic surgical procedures-both diagnostic and therapeutic. VATS thymectomy is being practised more and more replacing conventional thymectomy with thoracotomy/sternotomy. Methods From 2000 to 2003 we have performed 22 cases of VATS thymectomy in Myesthenia Gravis. Surgery was performed in supine decubitus under General anaesthesia with Double Lumen E T Tube for epsilateral Lung Collapse. Three ports were made on the right chest at 2nd space parasternal, 4th space anterior axillary line and at 5th space just below the nipple. At the end of the procedure a chest drain was introduced through the lowest port. Results Out of 22 patients 12 were females and 10 males. Median age was 36 years (Range 16 years to 64 years). Median operating time was 2 hours and drainage was 200 ml. Median ventillation time was 6 hours. Median hospital stay was five days. There was no mortality and no major complications. Conclusion VATS thymectomy is a suitable alternative to conventional thymectomy with thoracotomy/sternotomy. Results are comparable. VATS is now developing into an exciting adjunct in thoracic surgery. The morbidity associated with this procedure is extremely low. VATS has become an essential component of all thoracic surgical units and more and more thoracic surgical dieases will be managed with this minimally invasive technique in future.