[Thoracoscopic surgery of mediastinal tumor].

The successful key of video-assisted thoracic surgery (VATS) to mediastinal tumors (MTs) should be the correct choice of surgical approach according to anatomical positions and relationships between large vessels and tumors. The middle and posterior MTs are good indications of VATS with intercostal approach under lateral position. The superior MTs are usually not indicated to VATS because of anatomical complexity of nerves and vessels of this area Thymus is the most frequent site of MTs and is in the narrow anterior mediastinum between sternum and heart. So that VATS to the anterior MTs needs some sternal lifting devices to get working space with appropriate combinations of intercostal, infrasternal and cervical approaches under supine position. Benign neurogenic tumors and congenital cysts are good indications of VATS. Thymic cyst, benign thymic tumor. such as mature teratoma, and small thymoma [noninvasive, diameter less than 5 cm, caudal position from left brachiocephalic vein (LBCV)] are now also indicated to VATS. Vessel sealing system LigaSure V is a computer control bipolar electric scalpel and be able to seal and cut safely up to diameter 7 mm vessels. LigaSure is suitable instrument for thymic vein handling, for esophageal muscle cutting, and for inflammatory teratoma dissection. This device is an essential device for VATS of MTs. The cases of mature teratoma and esophageal cyst were presented.