Extended transsternal thymectomy.

Extended transsternal thymectomy allows for the safe excision of the gross thymus as well as perithymic and anterior mediastinal fat and lymphatic tissue that may harbor foci of aberrant thymus. Additionally, it permits direct inspection of each pulmonary hilum for suspicious thymic remnants and even small thymomas not visualized on the CT scan. It achieves the objective of a safe, well-tolerated operation that provides the best chance for remission or improvement in the patient with myasthenia gravis.