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Artificial pneumomediastinum facilitates thoracoscopic surgery in anterior mediastinum

^a Department of General Thoracic Surgery, Takarazuka Municipal Hospital, Takarazuka, Japan
^b Medical Center for Translational Research, Osaka University Hospital, Suita, Osaka, Japan
^c Department of General Thoracic Surgery, Suzuka General Hospital, Suzuka, Japan

*Corresponding author. Department of Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, E-1, Suita-City, Osaka, 565-0871, Japan Tel.: +81-6-6879-3152; fax: +81-6-6879-3163.

E-mail address: utsumi{at}surg1.med.osaka-u.ac.jp (T. Utsumi).

A 67-year-old woman underwent a thoracoscopic resection of a large anterior mediastinal cyst. Before surgery, artificial pneumomediastinum was performed with a retrosternal technique. Injection of 400 ml of air from the sternal notch caused emphysema throughout the mediastinum. In those areas, dissection of loose connective tissue was mostly accomplished by the injected air, which formed an air layer around the cyst. On the other hand, emphysema was not apparent in the areas around the left innominate and thymic veins. Artificial pneumomediastinum may be useful as a supplementary technique in a thoracoscopic surgery setting.

Key Words: Mediastinal tumor; Video-assisted thoracic surgery; Preoperative care; Thymus