Video-assisted thoracoscopy thymectomy for myasthenia gravis.

Over the past 8 years, the technique of video-assisted thoracoscopic surgery (VATS) thymectomy has continued to evolve. Although the procedure has become better defined and greater experience has been gained, numerous issues still exist. Whether it is best performed through a left sided, right sided, or as a bilateral approach with or without a cervical incision, is not clear. Equivalence of outcomes compared with more standard approaches to thymectomy is still an issue. Experience still is relatively limited to a few centers, and follow-up still is relatively short. In the author's own experience, it seems that availability of the less invasive approach has allowed thymectomy to be performed earlier in the course of the disease especially in young female patients in whom cosmesis is an important issue.