Robotic resection of a thymoma behind the left innominate vein

Abstract

Anatomical variations of one or both thymic upper poles located behind the left innominate vein (LIV) are found in some patients; however, minimally invasive dissection of ectopic thymic tissues behind the LIV is technically complex. We describe a case of a dumbbell-shaped thymoma behind the LIV. The patient was successfully treated with trans-subxiphoid robot-assisted thoracoscopic extended thymectomy. Both the LIV and tumour capsule were preserved intact. In our opinion, robotic surgery might expand the indications for minimally invasive thymectomy. It can be applied in selected difficult cases and sternotomy can be avoided in some situations.