• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2024 Scientific Session Call For Abstracts
      • 2024 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Robotic Thoracoscopic Radical Thymectomy for Myasthenia Gravis

Introduction: A complete, radical “phrenic-to phrenic” thymectomy is the standard of care for myasthenia gravis. Patients with myasthenia gravis (MG) are often poor candidates for median sternotomy because of their significant doses of immunosuppresive drugs and/or compromised respiratory function secondary to their MG. We hypothesized that a complete, radical thymectomy could be performed thoracoscopically using the Da Vinci robot and would be better tolerated than a sternotomy in patients with MG.
Methods: We retrospectively reviewed prospectively collected data on all thymectomies performed for MG since we performed the first robotic thoracoscopic (VATS) thymectomy at our institution, in April 2006. Patient characteristics such as: BMI, immunosuppresive medications, other co-morbidities (CAD, HTN, asthma, COPD, etc.), peri-operative complications (wound infection, pneumonia, post operative blood products) and length of stay (LOS) were compared in patients undergoing thymectomy via an open (median sternotomy) versus a robotic (left VATS) approach.
Results: Between 4/06 and 8/07, 13 patients underwent thymectomy for MG. Three patients had open, transsternal thymectomies via median sternotomy during this period. One patient was approached primarily via a median sternotomy due to a BMI of 40. The remaing 12 patients were positioned supine with a shoulder role and the table planed ~45 degrees; left side up. In 2 morbidly obese patients (BMIs 36.7 and 37.2), both with asthma, a thoracoscope was introduced initially into the left hemithorax. However, due to their inability to tolerate one-lung ventilation, the left VATS approach was aborted and a sternotomy was performed without repositioning. Ten patients (median BMI 32.5) underwent a succesful robotic thymectomy via a left VATS approach with complete excision of the mediastinal fat pad and entire thymus. No patient required perioperative blood transfusion or emergent conversion to open procedure for bleeding. There were no post-operative complications in either group. Median LOS was 3 days after an open, transternal approach versus 1 day after a robotic, left VATS approach.
Conclusion: A robotic radical thymectomy via a left VATS can be performed safely in patients with MG and is associated with a shorter LOS than median sternotomy. Morbid obesity and/or asthma may be relative contraindications to a robotic VATS approach. Long term follow up is necessary to determine the true efficacy of a minimally invasive, robotic VATS radical thymectomy on symptoms in patients with MG.


Session: Poster

Program Number: P395

View Poster

229

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2008 abstract archive

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064
1-310-437-0544
sagesweb@sages.org
Monday - Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons