Video-assisted thoracoscopic extended thymectomy using the subxiphoid approach

Minimally invasive thoracoscopic surgery has become an inevitable trend in the treatment of anterior mediastinal tumors and other thoracic diseases. Many surgical approaches may be used for video-assisted thoracoscopic surgery (VATS) thymectomy. Some researchers have proven that that VATS thymectomy using the subxiphoid approach is technically safe and feasible. Compared with the transthoracic approach, the subxiphoid approach is considered to provide a better view of the bilateral pleural cavities and to cause relatively less pain; it is thus considered a less invasive surgical approach. In this article, we summarize our experience with various incision designs, specific surgical procedures, and key operative manipulations that are crucial for successful performance of subxiphoid VATS extended thymectomy.