Removing Mediastinal Masses
There are many types of mediastinal masses, and treatment depends on the type of mass and its location.
The thoracic surgeons at Swedish specialize in the diagnosis and treatment of these masses. In appropriate cases, they are able to use the daVinci Surgical System to treat patients with:
- Early stage lung cancer
- Thymic disease such as thymomas
- Myasthenia gravis
- Duplication cysts
Robotic procedures are done in an operating room, with a specially trained surgical staff. Patients are under general anesthesia, and constantly monitored by an anesthesiologist.
Procedures may vary, depending on the exact location of a mass, but typically:
- The thoracic surgeon makes three incisions in the side of the chest; each incision is one to two centimeters long
- Specially designed surgical instruments and a tiny camera are attached to robotic arms and precisely inserted through the incisions
- The surgeon then sits at a nearby console, controlling every movement of the robotic tools
- The surgeon cuts the mass away from the chest structure holding it, and removes it through one of the incisions. If necessary, the incision is made a little larger to remove the mass in one piece so a pathologist can study it
- The instruments are then removed, and the incisions sutured closed
The precision instruments allow for maximum dexterity and control, with motions that mimic the human wrist. They are particularly well-suited for dissecting around a solid mass.
Other robotic procedures to remove mediastinal masses include:
Gaining access to masses inside the chest has traditionally been by sternotomy: cutting a long incision in the chest and then spreading apart the breastbone.
Patients who undergo a sternotomy to remove masses are in the hospital at least four to five days, and must limit activity for up to six weeks.
In comparison, patients who have robotic surgery for mediastinal masses:
- Remain in the hospital one to two days
- Have smaller, much more cosmetically appealingly scars
- Are back to work much sooner
- Have significantly less pain during the healing process
All surgeries involve some degree of risk, and discussing this with your doctor is an important part of preparing for any surgery. Fortunately, complications from robotic surgery are uncommon.
The robotic procedure also has far less infection and other complications from an open procedure such as a sternotomy.
Robotic surgical systems are now widely available, but that does not mean every surgeon is qualified to perform robotic surgery. Thoracic robotic surgery, in particular, is a fairly recent advancement – one that requires both skill and experience to be done right.
This makes it particularly important to find an experienced surgeon who works in a specialty center where robotic surgeries are routinely performed.
When you interview surgeons you are considering, be sure to ask:
- How long has robotic surgery been available at their center?
- How many robotic procedures are performed in their center each year?
- How experienced is the surgeon in performing robotic thoracic procedures?
Swedish is a regional center for performing – and teaching – robotic surgery. More than 4,000 robotic procedures have been performed here and everyone on our robotic surgery teams is specially trained and highly experienced.
Our thoracic surgeons are among the most experienced in the country in performing robotic thymectomies.
They were pioneers in VATS surgery, and the first in Seattle to perform robotic thoracic surgery. They have presented their data nationally, and teach robotic techniques to surgeons from around the country.