Totally thoracoscopic surgical resection of left ventricular benign tumor

Objective: The study objective was to explore the feasibility and safety of totally endoscopic resection of a left ventricular tumor through small chest incisions without robotic assistance. Methods: Four patients with a left ventricular tumor (1 papillary fibroelastoma, 1 lipoma, and 2 myxomas) underwent surgery with peripheral cardiopulmonary bypass. The mean age of patients was 58 & PLUSMN; 15 years. There were 3 female patients and 1 male patient. Through 3-port incisions in the right chest, pericardiotomy, bicaval cannulation, cardiac arrest, and atriotomy, left ventricular tumor resection was performed under thoracoscopy. Results: All patients had successful resections. The cardiopulmonary bypass and aortic crossclamp times were 110 & PLUSMN; 14 minutes and 58 & PLUSMN; 19 minutes, respectively. The length of stay in the intensive care unit was 38 & PLUSMN; 27 hours. There were no mortalities or complications in this cohort. Patients were discharged 7 days after the operation. Transthoracic echocardiography showed that the cardiac tumor was completely removed without any residue 3 months after surgery. Conclusions: Totally endoscopic left ventricular tumor resection without a robotically assisted surgical system is feasible and reproducible. This technique could minimize surgical trauma and achieves complete tumor resection. (JTCVS Techniques 2023;20:116-22)