Subxiphoid robotic thymectomy for myasthenia gravis

The robotic system provides a three-dimensional (3D) visual field and has articulated forceps that function in a manner similar to the human wrist, which enables natural dissection, resection, and suturing manipulations. In the present paper, the history and current state of robot-assisted thymectomy for myasthenia gravis (MG) are presented, and the surgical procedure for subxiphoid robotic thymectomy for MG is described. In robot-assisted thymectomy by a subxiphoid approach, the insertion of a camera through the subxiphoid incisional wound enables observation of the entire innominate vein, and the presence of robotic articulations in the mediastinum enables the surgeon to easily and safely tape the blood vessels. Therefore, robot-assisted subxiphoid thymectomy enables minimally invasive thoracoscopic surgery to be performed on patients who have been unsuitable candidates for thoracoscopic surgery, and indications for thoracoscopic thymectomy have increased. Future improvements in robot-assisted systems may enable surgery that cannot be currently performed by human hands to be completed by robot-assisted surgery.