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Background: It is very rare for a thymic cyst to manifest as a lateral neck swelling. It usually requires a cervical incision and a sternotomy for complete resection. We have a series of 3 pediatric patients who were managed by a combined mediastino-cervical approach using VATS and would share one such video.
Materials and Methods: Between August 2014 and May 2015, 3 pediatric patients (<10 years) presented in the out patient with intermittently appearing painless neck swelling especially upon coughing. All were diagnosed to have mediastino-cervical cysts and they underwent simultaneous resection of neck component by a transverse cervical incision and mediastinal component resection by VATS.
Results: All 3 cysts were left sided and their mediastinal component was seen arising from the substance of thymus gland. Mediastinal resections could be completed by VATS. Chest drains were removed on 1^st POD in all patients. One patient developed left lower lobe atelectasis
Conclusion: The use of VATS for resection of mediastinal part of thymic cysts helps avoid a big sternotomy in these young group of patients, leading to a quicker and less painful recovery and gives better cosmesis.