Left innominate vein wrapping with Dacron sheath after thymectomy

BACKGROUND: Any type of radical thymectomy, open or thoracoscopic, always results in a skeletonized left innominate vein (LIV), which is highly expected to form adhesions to the posterior surface of the sternum. Therefore, in case of future sternotomy, the LIV remains highly exposed to trauma. METHODS: We describe a surgical technique that is expected to protect the innominate vein in case of future sternotomy. RESULTS: Our technique is not technically demanding, is easily reproducible, can be applied in both open and thoracoscopic procedures and does not significantly prolong the overall duration or cost of the procedure. CONCLUSIONS: Our alternative is the only protective measure for the left innominate vein that can be applied in the first operation and in our opinion should be a standard part of the procedure.