Difficult Decisions in Minimally Invasive Surgery of the Thymus

SIMPLE SUMMARY: The trend for thymoma surgery has been to increase utilization of minimally invasive options for resection; however, the primary objective should be to perform an oncological resection. One must consider the stage of tumor, presence of myasthenia gravis, presence of lymphadenopathy, and size of thymoma prior to deciding optimum surgical strategy. ABSTRACT: A minimally invasive resection of thymomas has been accepted as standard of care in the last decade for early stage thymomas. This is somewhat controversial in terms of higher-staged thymomas and myasthenia gravis patients due to the prognostic importance of complete resections and the indolent characteristics of the disease process. Despite concerted efforts to standardize minimally invasive approaches, there is still controversy as to the extent of excision, approach of surgery, and the platform utilized. In this article, we aim to provide our surgical perspective of thymic resection and a review of the existing literature.