Aim: The advantages and feasibility of video-assisted thoracoscopic surgery (VATS) in the surgical management of early resectable thymoma and thymic hyperplasia have largely been described and adopted in many thoracic surgery units. In order to allow for resection of all immunogenic thymic cells in patients with myasthenia gravis, surgical removal of the whole thymus gland including perithymic and pericardiophrenic fatty tissue becomes imperative. It is also important to achieve radical

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... n and excision in cases of thymoma. Methods: Numerous technical variations of VATS thymectomy have been reported in literature. In this study, the surgical technique of a minimally invasive, extended thymectomy through a bilateral approach is illustrated with key features highlighted. Results: In our experience, no conversion to the open transternal approach, surgical mortality or major complications were observed; the median length of hospital stay was 3 days. Conclusion: Bilateral video-assisted extended thymectomy is an effective, safe and well-tolerated approach, with surgical benefits and clinical outcomes similar to other thoracoscopic techniques.