Laparoscopic Thymectomy for Myasthenia Gravis
Myasthenia Gravis (MG) is a chronic disease affecting neuromuscular transmission resulting in debilitating weakness. The thymus gland is thought to play a key role in the disease. The basic problem involves blockade of muscle (acetylcholine) receptors by antibodies formed by our own immune system. Damage to the receptor and impaired neuromuscular transmission leads to symptoms of weakness and fatigue.

Treatment of this potentially debilitating disorder includes anticholinesterase drug therapy, steroids immunosuppressive agents, plasmapheresis, and surgical removal of the thymus (thymectomy).

Thymectomy is now recommended for most patients with generalized symptoms. Approximately 80% of patients will enjoy a significant benefit and even remission from their myasthenic symptoms following thymectomy. Interestingly, the benefits of the procedure may not be seen for months following resection.

Numerous surgical options exist for MG. The transternal approach is via a midline incision in the sternum and is the most widely utilized. However, recently we have applied minimal access approaches that allow for equivelant resection of the thymus through small less invasive incisions. These include the transcervical approach, where a small incision is created in the neck only as well as video-assisted thoracoscopic approaches that utilize small chest incisions and operating telescopes. We are very enthusiastic about these approaches and have been impressed by our patients' quick recovery and decreased postoperative discomfort.