[Minimally invasive surgery for mediastinal disease patients performed with special skills such as hand-assistance].

From 1997 to 2005, we performed endoscopic surgery on the thymus in 163 patients with myasthenia gravis or thymoma. The outcomes in these patients were analyzed, with the following conclusions obtained. Endoscopic extended thymectomy is acceptable as a standard operative procedure for myasthenia gravis patients. Endoscopic surgery on the thymus is indicated for stage II or less advanced cases of thymoma according to Masaoka classification. When hand-assisted thoracoscopic surgery (HATS) is used for surgery on the thymus, median sternotomy is not required. If applied only to cases in which it is truly indicated, endoscopic surgery on the thymus can be expected to shorten operative time compared with conventional operative procedures requiring median sternotomy and to serve as minimally invasive surgery in the true sense of the term.