Minimally invasive anterior chest wall lifting technique for thoracoscopic mediastinal approach.

Anterior chest wall lifting facilitates a wide view and allows easy access during thoracoscopic surgery in a supine position for anterior mediastinal lesions. We previously reported an anterior chest wall lifting method for a thymectomy that utilizes our original costal hooks. Here, we present a less invasive method that can be performed with only a needle puncture, i.e., a metal plate placed under the ribs is lifted with a wire inserted through the anterior chest wall. We have applied this novel 'T-lifting method' for 5 different cases with anterior mediastinal tumors, and found it to be simple and easy to perform, as well as less invasive for patients undergoing thoracoscopic surgery.