Robotic Thymectomy

  • Federico ReaEmail author
  • Giuseppe Marulli


In this chapter, we describe a minimally invasive surgical technique for thymectomy with mediastinal fat removal by left-sided thoracoscopy enhanced by the use of the “da Vinci” robotic system. A detailed description of technique, its application, tips and pitfalls, and results are discussed.


Intercostal Space Phrenic Nerve Anterior Axillary Line Mediastinal Pleura Phrenic Nerve Injury 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Rea F, Bortolotti L, Girardi R, Sartori F (2003) Thoracoscopic thymectomy with the Da Vinci surgical system in patient with myasthenia gravis. Interact Cardiovasc Thorac Surg 2:70–72PubMedCrossRefGoogle Scholar
  2. 2.
    Rückert JC, Ismail M, Swierzy M, Sobel H, Rogalla P, Meisel A, Wernecke KD, Rückert RI, Müller JM (2008) Thoracoscopic thymectomy with the da Vinci robotic system for myasthenia gravis. Ann N Y Acad Sci 1132:329–335PubMedCrossRefGoogle Scholar
  3. 3.
    Augustin F, Schmid T, Sieb M, Lucciarini P, Bodner J (2008) Video-assisted thoracoscopic surgery versus robotic-assisted thoracoscopic surgery thymectomy. Ann Thorac Surg 85:S768–S771PubMedCrossRefGoogle Scholar
  4. 4.
    Castle SL, Kernstine KH (2008) Robotic-assisted thymectomy. Semin Thorac Cardiovasc Surg 20:326–331PubMedCrossRefGoogle Scholar
  5. 5.
    Fleck T, Fleck M, Müller M, Hager H, Klepetko W, Wolner E, Wisser W (2009) Extended videoscopic robotic thymectomy with the da Vinci telemanipulator for the treatment of myasthenia gravis: the Vienna experience. Interact Cardiovasc Thorac Surg 9:784–787PubMedCrossRefGoogle Scholar
  6. 6.
    Goldstein SD, Yang SC (2010) Assessment of robotic thymectomy using the myasthenia gravis foundation of America guidelines. Ann Thorac Surg 89:1080–1085PubMedCrossRefGoogle Scholar
  7. 7.
    Marulli G, Schiavon M, Perissinotto E, Zuin A, Di Chiara F, Rebusso A, Battistella L, Rea F (2010) Safety and long-term efficacy of left thoracoscopic robot enhanced thymectomy in patients with myasthenia gravis. Interact Cardiovasc Thorac Surg 11(S1):S49Google Scholar
  8. 8.
    Freeman RK, Ascioti AJ, Van Woerkom JM, Vyverberg A, Robison RJ (2011) Long-term follow-up after robotic thymectomy for nonthymomatous myasthenia gravis. Ann Thorac Surg 92:1018–1022PubMedCrossRefGoogle Scholar
  9. 9.
    Masaoka A, Yamakawa Y, Niwa H, Fukai I, Kondo S, Kobayashi M, Fujii Y, Monden Y (1996) Extended thymectomy for myasthenia gravis: a 20-year review. Ann Thorac Surg 62:853–859PubMedCrossRefGoogle Scholar
  10. 10.
    Cooper JD, Al-Jilaihawa AN, Pearson FG, Humphrey JG, Humphrey HE (1988) An improved technique to facilitate transcervical thymectomy for myasthenia gravis. Ann Thorac Surg 45:242–247PubMedCrossRefGoogle Scholar
  11. 11.
    Mineo TC, Pompeo E, Lerut T, Bernardi G, Coosemans W, Nofroni I (2000) Thoracoscopic thymectomy in autoimmune myasthenia: results of left-sided approach. Ann Thorac Surg 69:1537–1541PubMedCrossRefGoogle Scholar
  12. 12.
    Mack M, Landreneau R, Yim A, Halzelrigg S, Scruggs G (1996) Results of video-assisted thymectomy in patients with myasthenia gravis. J Thorac Cardiovasc Surg 112:1352–1360PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Division of Thoracic Surgery, Department of Cardiologic, Thoracic and Vascular SciencesUniversity Hospital of PaduaPaduaItaly

Personalised recommendations