title: Minimally-invasive complete resection of intrathoracic mediastinal lesions with a Linder-Dahan spreadable-blade video mediastinoscope system: A report of two cases.
abstract: BACKGROUND
  Cervical mediastinoscopy can provide a minimally invasive access to the paratracheobronchial mediastinum within its reachable range, but its operability is substantially limited because of its small operative field, poor visualisation, and one-handed operation.
  
  
  METHODS
  Patient 1, a 56-year-old woman, presented with a 22×17mm, non-symptomatic, (18)F-fluorodeoxy glucose (FDG)-avid, solid schwannoma originating from the vagus nerve trunk in the right upper paratracheal space. Patient 2, a 55-year-old man, presented with a 55×41mm cystic mass in the left upper paratracheal space that extensively compressed and dislocated the trachea toward the right, which caused dyspnoea and cervicothoracic pain. The masses in both cases were completely resected using a Linder-Dahan spreadable-blade video mediastinoscope.
  
  
  CONCLUSIONS
  The addition of the video system and spreadable blades to the conventional scope combined with a scope-holding device has enabled effective bi-manual preparation and more precise and safer mediastinoscopic procedures than those performed using the conventional one-handed mediastinoscope. Owing to the improved operability, more complex or extended procedures could be performed in wider and more stable operative spaces with better visualisation, although the system has the same minimal invasiveness as that of the conventional mediastinoscope.
  
  
  CONCLUSIONS
  We describe two patients with mediastinal lesions that were effectively resected by using this sophisticated video mediastinoscope system.
authors.affiliation: Department of Thoracic Surgery, Uji Tokushu-kai Hospital, Kyoto, Japan. Electronic address: itano_h@yahoo.co.jp.
authors.forename: Hideki
authors.initials: H
authors.lastname: Itano
authors.affiliation: Department of Respiratory Medicine, Uji Tokushu-kai Hospital, Kyoto, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Takeda
authors.affiliation: Department of Surgery, Uji Tokushu-kai Hospital, Kyoto, Japan.
authors.forename: Hideto
authors.initials: H
authors.lastname: Nakahara
authors.affiliation: Department of Surgery, Uji Tokushu-kai Hospital, Kyoto, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kubota
authors.affiliation: Department of Surgery, Uji Tokushu-kai Hospital, Kyoto, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Nakai
keywords: Case report; Linder-Dahan video mediastinoscopy; Mediastinal tumour; Minimally invasive surgery