Surgical Tips to Improve Completeness of Transsubxiphoid Robotic Extended Thymectomy

Removal of adipose tissues located behind the left innominate vein and at the aortocaval groove is technically complex for minimally invasive extended thymectomy. The study describes the technical tips of the subxiphoid robotic procedure to remove these adipose tissues. Extended thymectomy by the presented procedure was performed in 39 patients, and 6 patients were diagnosed with ectopic thymic tissues behind the left innominate vein. Satisfactory short-term surgical outcomes demonstrated that dissection of adipose tissues located between mediastinal major vessels is technically feasible and safe by this novel procedure.