Hand assisted subxiphoid thoracoscopic surgery

A) The patient is in the supine position with the head to the left side of the photo. The surgeon's hand is inserted through a subxiphoid incision into the pleural cavity or mediastinum. One port for the camera (shown) and another port(s) for instruments such as energy devices, thoracoscopic staplers, and suction (not shown) are placed between the ribs.
B) The hand assist method allows full access of the mediastinum or pleural cavity including the apex.