PURPOSE: The goal of our study was to determine both the feasibility and the short-term efficacy of a minimally invasive, robotic-assisted, thoracoscopic (VATS)radical thymectcomy in patients with Myasthenia Gravis (MG).
METHODS: Since April 2006 radical thymectomies for MG have been performed thoracsocopically via left hemithorax with robotic assistance at our institution. All patient data were entered into an IRB-approved, prospective database. A retrospective review of all patients with MG undergoing a radical, robotic-assisted, VATS thymectomy was performed.
RESULTS: A total of 11 robotic-assisted, VATS radical thymectomies were performed between April 2006 and March 2008. The median patient age and weight were 32 years old and 89 kg, respictively. There were no perioperative complications; specificially there were no wound infections, prolonged ventilation >24 hours, pneumonia, pulmonary emboli or bleeding that required transfusion. Median LOS was 2 days (including day of surgery). Symptoms attributable to MG were improved or absent post-operatively in 91% (10/11) patients and 72% (8/11) had no symptoms attributable to their MG at a median follow up of 8 months. Immunosuppression was continued or initiated in the immediate post-operative period without delay in all patients by an attending neurologist.
CONCLUSION: A radical thymectomy can be performed thoracoscopically with robotic-assistance with low morbidity, short LOS and excellent short term neurologic results.
CLINICAL IMPLICATIONS: A robotic thoracoscopic approach affords excellent 3-D visibility and improved articulation which appears to allow a radical thymectomy to be performed minimally invasively. A robotic, VATS approach may be better tolerated by older, frail patients and/or more acceptable to younger (especially female)patients with MG.
DISCLOSURE: James Maloney, No Financial Disclosure Information; No Product/Research Disclosure Information