Laparoscopic transdiaphragmatic thymectomy without chest incisions.

Mediastinal parathyroid adenomas are rare. Surgical resection is recommended. Traditionally median sternotomy has been the preferred approach; newer less invasive techniques have been described. The aim is to describe an innovative technique for thymectomy via a laparoscopic transdiaphragmatic approach avoiding any thoracic incisions and potentially chronic postoperative intercostal pain in a patient with a well localized mediastinal parathyroid adenoma. No intraoperative complications, parathyroid hormone essay normalized and the patient was discharged home on the second day. Laparoscopic transdiaphragmatic thymectomy seems feasible and safe. Further studies are needed.