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Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 16, 2025; 13(35): 115700
Published online Dec 16, 2025. doi: 10.12998/wjcc.v13.i35.115700
Robotic subxiphoid surgical approach for mediastinal lesions: One-year experience
Alessandro Pardolesi, Michele Ferrari, Giovanni Leuzzi, Ugo Cioffi, Gerardo Cioffi, Piergiorgio Solli
Alessandro Pardolesi, Michele Ferrari, Giovanni Leuzzi, Piergiorgio Solli, Department of Thoracic Surgery, Istituto Nazionale Tumori, Milan 20133, Lombardy, Italy
Ugo Cioffi, Department of Surgery, University of Milan, Milan 20122, Lombardy, Italy
Gerardo Cioffi, Department of Sciences and Technologies, University of Sannio, Benevento 82100, Campania, Italy
Co-first authors: Alessandro Pardolesi and Michele Ferrari.
Author contributions: Pardolesi A and Ferrari M contributed to formal analysis, and they contributed equally to this manuscript and are co-first authors; Pardolesi A, Ferrari M, Leuzzi G, and Solli P contributed to data interpretation; Pardolesi A, Ferrari M, Leuzzi G, Cioffi U, Cioffi G, and Solli P contributed to writing - original draft and writing – review & editing; Pardolesi A, Ferrari M, and Solli P contributed to conceptualization; Pardolesi A and Solli P contributed to methodology; Ferrari M contributed to data curation. All authors read and accepted the final version.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Fondazione IRCCS Istituto Nazionale dei Tumori.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ugo Cioffi, Department of Surgery, University of Milan, Via Festa Del Perdono 7, Milan 20122, Lombardy, Italy. ugocioffi5@gmail.com
Received: October 24, 2025
Revised: November 26, 2025
Accepted: December 10, 2025
Published online: December 16, 2025
Processing time: 54 Days and 18.3 Hours
Core Tip

Core Tip: The subxiphoid robotic-assisted thoracic approach is an excellent alternative to traditional unilateral robotic and video-assisted minimally invasive techniques for the treatment of anterior mediastinal tumors. This method provides an unobstructed view of the mediastinal structures, allowing for the safe removal of larger lesions while maintaining direct control over both phrenic nerves. Furthermore, it is associated with less postoperative pain and better cosmetic outcomes. Based on our initial experience with 10 patients, the subxiphoid approach is a feasible, safe, and oncologically sound option for mediastinal dissection, even in cases where lesions exceed 5 cm in diameter.