Left-hand-dominant subxiphoid thoracoscopic thymectomy: a case series.

BACKGROUND

Left-handed surgeons face systemic ergonomic challenges in conventional right-oriented surgical environments. This study proposes a standardized left-dominant protocol for subxiphoid thoracoscopic thymectomy, integrating dual perspectives as a left-handed surgeon and surgical educator.

METHODS

This study describes a case series of 82 consecutive thymic mass resections, performed using the left-dominant subxiphoid thoracoscopic approach at Dalian Medical University.

RESULTS

We analyzed 82 patients, comprising 35 males (42.7%) and 47 females (57.3%). The mean age was 53.3 ± 12.8 years, and the mean tumor size was 4.0 ± 2.2 cm. Histopathological analysis identified 48 thymomas, classified according to WHO, Masaoka, and TNM staging systems, as well as 7 thymic carcinomas and other types. All cases achieved R0 resection without conversion to open thoracotomy. The remaining 81 patients (98.8%) experienced smooth recovery.

CONCLUSION

Our results suggest that this left-dominant approach is feasible, safe, and reproducible. The methodology introduces a standardized procedural framework for ambidextrous skill development, offering distinct ergonomic advantages for left-handed surgeons while maintaining compatibility with conventional right-handed techniques.