Surgery Today

, Volume 48, Issue 2, pp 195–199 | Cite as

A bilateral approach to extended thymectomy using the da Vinci Surgical System for patients with myasthenia gravis

  • Koji KawaguchiEmail author
  • Takayuki Fukui
  • Shota Nakamura
  • Tetsuo Taniguchi
  • Kohei Yokoi
Original Article



We adopted a bilateral approach to complete robotic extended thymectomy with the excision of the pericardial fat tissue from both sides and analyzed the initial outcomes.


The patient cart was docked first from the left shoulder side. After dissection of the thymus and right pericardial fat tissue, the cart was temporarily rolled out, and the bed was rotated approximately 90° clockwise. The cart was then re-docked from the right-side shoulder, and extended thymectomy was performed via the left-side approach. The outcomes were compared with four cases of unilateral approach performed for mediastinal tumor in the same term.


Four patients with myasthenia gravis (two of whom had stage I thymoma) underwent extended thymectomy by the bilateral approach. The mean operative time was 288 min, and the console time was 146 min in the right side and 67 min in the left side. The resected thymus and surrounding adipose tissue were almost symmetrical, in contrast with those obtained via the unilateral approach. No remarkable events were noted.


Bilateral extended thymectomy for myasthenia gravis patients was safe and reasonable based on the initial outcomes.


Robotic thymectomy Bilateral approach Myasthenia gravis 


Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest in association with this study.


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Copyright information

© Springer Japan KK 2017

Authors and Affiliations

  1. 1.Department of Thoracic SurgeryNagoya University Graduate School of MedicineNagoyaJapan
  2. 2.Division of Thoracic SurgeryKomaki City HospitalKomakiJapan

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