Key Points

• Thoracoscopic thymectomy is a safe and viable alternative technique for thymectomy in patients with MG.
• We prefer the right-sided approach, but there is no consensus on the ideal laterality for VATS thymectomy.
• Results of VATS thymectomy, in terms of complete stable remission from MG and symptomatic improvement, are comparable to those of conventional surgical techniques.
• VATS thymectomy results in less postoperative pain, better preserved early postoperative pulmonary function, and improved cosmesis, which is particularly important to many young, female MG patients who seek early surgical management.
• The future development of single port (uniportal) VATS thymectomy, better instrumentation, and camera systems, as well as image-guided VATS thymectomy performed in the hybrid operating theatre may further improve outcomes for patients undergoing VATS thymectomy.