The approach to the mediastinal space represents one of the most interesting applications of the Da vinci Robotic system due to the characteristics of the system that allows precise manipulation in narrow and short anatomical regions. A left sided or bilateral thoracoscopic approach for Robot assisted thymectomy is usually practised. This video shows a simplified right thoracoscopic approach for thymectomy in a patient with myasthenia.

An 18 year old patient with myasthenia gravis was referred to our unit for thymectomy. The operation was performed through a thoracoscopic right approach, using a four trocar technique.

The procedure was completed robotically with no conversion and no intraoperative morbidity. Operative time was 120 minutes. Estimated blood losses were 25 cc. The postoperative course was uneventful and the patient was discharged on postoperative day 2.

Right Thoracoscopic approach for robotic thymectomy, in our opinion, improves the dissection of upper thymic horns, control of thymic vein and provides an excellent access to the anterior mediastinum from a single-sided approach. The advantages of this minimally invasive approach are lesser postoperative pain, better preservation of respiratory function, improved cosmesis and faster recovery.