Robotic-assisted minimally invasive thymectomy for myasthenia gravis with thymoma.

12 While bilateral robotic and/or combined hybrid VATS/robotic approaches have also been advocated to directly visualize both phrenic nerves and pericardial fat basins from their respective ipsilateral sides, there may be significant barriers to adoption, given time needed for additional contralateral trocar placement, potential patient repositioning, possible redocking of the instrument arms (although this has simplified with subsequent generations of the robotic platforms), and increased patient pain. 13 In our robotic-assisted experience using bilateral simultaneous thoracoscopy with a single 5-mm contralateral port, we believe the benefits of both left- and right-sided approaches are realized without several of the aforementioned disadvantages.

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