Floating Intercostal Port Technique for Single-Port Robotic Resection of Posterior Mediastinal Schwannomas: A Case Report

Single-port (SP) robotic thoracic surgery is a minimally invasive option for mediastinal tumor resection; however, intercostal access remains challenging due to narrow intercostal spaces and the risk of postoperative neuralgia. This report describes 2 cases of posterior paravertebral mediastinal schwannoma resected using a floating intercostal port technique with the da Vinci SP system. In each case, a small uniportal incision was made at the lowest feasible intercostal space without rib spreading, and the SP metal port was positioned in a floating configuration above the intercostal space to reduce nerve compression while allowing safe instrument deployment. Complete tumor resection was achieved in both patients without intraoperative complications. Postoperative recovery was uneventful, with minimal pain and no intercostal neuralgia. The floating intercostal port technique may facilitate safe and effective SP robotic resection of selected posterior mediastinal tumors while preserving the advantages of intercostal access and supporting early recovery.