Abstract Background Esophageal leiomyoma is a benign tumor originating from the smooth muscle cells of the esophagus. It is the most common type of esophageal tumor and is often discovered incidentally during imaging studies due to its typically asymptomatic nature. Surgical resection remains the primary treatment option. Methods A 47-year-old male patient was incidentally diagnosed with a mid-esophageal submucosal tumor (SMT) during surveillance for another malignancy. Thoracoscopic resection was performed. A camera trocar was inserted in the 9th intercostal space, and three additional working trocars were placed in the 5th and 7th intercostal spaces. The tumor’s location was confirmed grossly, and dissection was carried out around the mid-esophagus to precisely localize the lesion. The mass was identified on the left side of the esophagus and was excised after submucosal dissection. Results The mucosal layer was preserved, and the excision site was closed primarily using 3–0 V-Loc sutures. The specimen was retrieved in a wrapped bag. The patient was discharged without complications on postoperative day six. Histopathological examination confirmed esophageal leiomyoma. Conclusion This case demonstrates that thoracoscopic surgery can be safely and effectively used for the resection of small esophageal submucosal tumors with minimal invasiveness and excellent surgical visualization, leading to precise excision with minimal morbidity. Video Descrption This video demonstrates the thoracoscopic resection of a mid-esophageal leiomyoma that was incidentally discovered during surveillance imaging for an unrelated malignancy in a 47-year-old male patient. The procedure highlights key steps including trocar placement, precise localization of the tumor, careful submucosal dissection with mucosal preservation, and primary closure using barbed sutures. The case emphasizes the safety and efficacy of a minimally invasive thoracoscopic approach in managing benign esophageal tumors. This video is particularly relevant for the Congress as it showcases a refined, organ-preserving technique that can be applied to similar intrathoracic SMTs, contributing to improved postoperative outcomes and recovery. It offers practical insights into operative planning and execution for thoracic surgeons managing small esophageal masses.
Shin et al. (Fri,) studied this question.