Minimally invasive techniques using LigaSure^TM in chest wall resection: Sparing the overlying, uninvolved extrathoracic musculature

Abstract

We discuss minimally invasive techniques using LigaSure^TM in chest wall resection. A patient with a metastatic chest wall tumor from a renal cell carcinoma underwent 8th-10th rib chest wall resection. A primary incision of 10 cm was made posteriorly over the ninth rib, followed by posterior chest wall dissection through this incision. The intercostal muscles and vessels were divided using LigaSure^TM, and the dissection continued anteriorly using LigaSure^TM with visual monitoring using a thoracoscope. Dissection of the anterior edge of the chest wall was difficult through the main incision, and a utility port was added anteriorly to divide the anterior edge of the ribs under direct vision. LigaSure^TM was effectively and easily used to divide the intercostal muscles and vessels. Chest wall resection using LigaSure^TM via video-assisted thoracoscopic surgery was suggested to be an effective, minimally invasive approach for chest wall tumor resection.