University of Wisconsin Hospital and Clinics physicians provide comprehensive treatment, including robotic surgery, for myasthenia gravis (MG), a chronic disease affecting neuromuscular transmission that typically results in debilitating muscle weakness.
The thymus gland is involved in the development of the immune system, which enables the body to defend itself against infection. The thymus produces certain cells, called T-cell lymphocytes, which are a vital part of the immune system. These T-cell lymphocytes stimulate the production of antibodies whose job it is to recognize and fight off foreign invaders called antigens, that enter our body.
Normally the antibodies destroy the antigens before major illness occurs. The basic problem that produces MG, however, involves a blockade of muscle (acetylcholine) receptors by some of these antibodies, which does harm instead of good. Damage to the receptors and impaired neuromuscular transmission ultimately leads to symptoms of weakness and fatigue.
For those suffering from MG, there are several types of treatment options available, of which one is surgery. Typically this involves the removal of the thymus gland. This process is called a thymectomy.
The current incision choices for a thymectomy are a median sternotomy (sternal splitting or straight vertical incision), transverse transcervical (neck) incision and thoracoscopic incisions with or without a robot.
da Vinci® Thymectomy: Less Invasive
If your doctor recommends surgical repair, you may be a candidate for a new, less invasive surgical procedure called da Vinci Thymectomy. This procedure uses a state-of-the-art surgical system designed to help your surgeon see vital anatomical structures more clearly and to perform a more precise operation.
For most patients, da Vinci Thymectomy offers numerous potential benefits over traditional open-chest surgery, including:
- Shorter hospital stay
- Less pain and scarring
- Less risk of infection
- Less blood loss and fewer transfusions
- Faster recovery
- Quicker return to normal activities
As with any surgery, these benefits cannot be guaranteed, as surgery is patient and procedure specific. To learn more about da Vinci Thymectomy, talk with your doctor.
In this procedure, three tiny incisions are made, usually in the left chest. A small scope, as well as the robotically-controlled instruments are introduced into the body via these port sites.
The 3-D visibility afforded by the Da Vinci™ robot and the fine, articulating, movements of the robotic arms enable the thymus gland to be carefully separated from surrounding structures and removed intact using a sterile bag.
The total incision is less than one inch. Cutting of the sternum and spreading of the ribs are not required.
The procedure now takes about two hours and most patients go home in less than 24 hours.
When patients wake up from general anesthesia, they will have a small chest tube. This helps to re-expand the lung and to drain any fluid that may have accumulated during the case.
In most instances, the chest tube is removed the next morning and patients usually go home within 24 hours post-surgery. Post-operative recovery is shorter with the minimally invasive surgery described above as compared to an open procedure. Patients may require low dose pain medication for 1-2 weeks following surgery.