Median sternotomy for thymectomy

The precise boundaries of the thymus gland can vary. Intraoperatively, the thymus gland is indistinguishable from cervical and mediastinal adipose tissue. Thus, for a complete resection (R0), all tissue is removed anterior to the pericardium from the innominate vein superiorly to the diaphragm inferiorly, and laterally from the left to the right phrenic nerves.