The mean tumor size was 4,09 cm (range: 3 to 11 cm). Figure 1.CT-scan image showing a 11 cm giant anterior mediastinal Thymoma, successfully resected by 2 portal VATS access of the left hemithorax. Mean blood loss and operative time were significantly lower in the video-assisted thoracoscopic surgery versus open surgery.There was no 30-day mortality. Reoperation was not required. Lenght of hospital stay 3,5 days (range 2-9 days). Mean follow up was 20 months, with no tumor recurrence. Conclusion: Unilateral and bilateral VATS approaches have demonstrated good long-term oncologic and neurologic results with low complication rates. Reduced blood loss, operative time and earlier hospital discharge.