Thymectomy remains a therapeutic challenge in elderly patients with thymoma associated with myasthenia gravis (MG). Thymectomy, in the multimodality therapy of these patients should be discussed by multidisciplinary expert teams. Available data show that robotic thymectomy seems to be as safe and as effective as an open procedure with better short-term outcomes and with at least the same quality of oncologic resection. Nevertheless, data are limited on the safety and effectiveness of robotic thymectomy in elderly patients. We present here, our surgical technique of robotic radical en bloc thymothymectomy that we use in all our patients with thymoma associated with MG, with particularities related to elderly patients. We also review the medical and surgical literature on robotic thymectomy for thymoma and MG. The robotic platform allows us to "mimic an open procedure by a minimally invasive approach", and thus, we are able to perform a complete and radical thymothymectomy comparable to open procedure with the same quality of oncologic resection, but with the advantages of a minimally invasive approach regarding short-term outcomes.
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