Vintage trans-sternal approaches: Consigned to the graveyard

{Figure 1} The article 'Expansile manubriotomy for ventral cervicothoracic junction lesions' written by Dubey and colleagues [1] is excellent, and we as one of the groups who routinely do this procedure for indicated ventral cervicothoracic lesions, appreciate the authors' interest in this approach. [...]we are of the view that the surgeons who perform the exposure should also be versatile in tackling the complications that may arise in that region, which in this case, are predominantly related to the thoracic cavity and the mediastinum. The luxury of being closer to the lesion in the conventional open approaches to the lesions in this area has been taken away by all of the modifications of the approach that have been introduced for the benefit of attempting to decreasing morbidity; the primary goal of progress in surgery, however, is to try to optimize exposure while reducing complications and one must accept the role of minimally invasive approaches in attempting to achieve this goal.