Resection of residual mediastinal germ cell masses with the Cavitron ultrasonic surgical aspirator

Residual mediastinal masses after chemotherapy for germ cell tumors should be resected. Complete excision of bulky residual masses may sometimes be difficult because of problems with exposure in the region of the great vessels and important nervers. Two cases are presented in which the Cavitron ultrasonic surgical aspirator (Valleylab Inc., Surgical Systems Division, Stanford, Conn.) facilitated excision of large masses after intensive chemotherapy. We found that the collapsed pseudocapsule remaining after aspiration of tumor mass allowed early improved exposure and safer dissection from neighboring vessels and neural structures. Complete excisions were accomplished and no viable tumor was found, so that the patients were spared the immediate need for further therapy. Both had uneventful recoveries