Red flags in minimally invasive thymoma resections

Despite all the efforts for the standardization of the minimally invasive procedures for mediastinal mass lesions, there still exists traps for surgeons to fall into. In this manuscript, possible red flags are discussed. This could prevent a minimally invasive surgeon from meeting possible problems related to the minimally invasive intervention. Operating on a non-thymomatous, non-myasthenia gravis (MG) thymus (useless surgery) is one of the most common problems that a minimally invasive thoracic surgeon could meet. Performing thymomectomy instead of thymothymectomy, in order to perform the operation minimally invasively, is another potential problem. Technically difficult or oncological risky operation is another red flag. These operations could be performed by some surgeons who had the chance to develop their minimally invasive surgery (MIS) capabilities. However, not so many surgeons could demonstrate similar performance. Insisting on not converting to open surgery although it is necessary. This may cause major morbidity or even mortality which is the reddest flag.