We describe the various video-assisted thoracic surgery approaches to the thymus currently adopted in nonthymomatous and thymomatous myasthenic patients. Despite several controversies, video-assisted thoracic surgery thymectomy gained worldwide popularity. Classic 3-port approaches proved safe and effective. Uniportal video-assisted thoracic surgery requires consolidated experience, whereas the bilateral approach is considered more extensive. Subxiphoid represents the ultimate and exciting challenge. As an effect of video-assisted thoracic surgery approach, thymectomy is performed earlier; both patients and neurologists are more prone to accept the procedure given the quicker recovery, lesser pain, and better cosmesis. Outcomes are equivalent to those achieved by sternotomy.
Keywords: Myasthenia gravis; Thymectomy; Thymoma; Uniportal VATS; VATS.
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