Myasthenia Gravis Treatments
The condition may be controlled with medications including immune suppressants.
Surgical removal of the thymus gland greatly improves the condition (70% of patients), and in some cases resolves myasthenia gravis. But the treatment has been controversial because it does not help all patients.
Our team approach—including specialists in neurology, pain management, pulmonology, and critical care—has dramatically improved the effectiveness and safety of thymectomy, which can now be recommended even for patients with advanced muscle weakness.
Thymectomy, surgery to remove the thymus gland, has traditionally been performed as an open procedure in which the central breast bone, or sternum is cut, and the chest opened (sternotomy).
Transcervical Thymectomy
Columbia is one of a few institutions perfoming transcervical thymectomy, a minimally invasive procedure in which the thymus is removed through a small incision in the lower part of the neck. The procedure is viewed through a video camera inserted together with small surgical instruments through a small horizontal incision across the lower part of the neck. Benefits of this procedure, as compared to the open procedure, include a dramatically faster recovery period and less postoperative pain. Typically, the patient is in the hospital only one day and can return to work and normal activity within a week. Not all patients are candidates for the transcervical approach.
Thoracoscopic Thymectomy
The procedure may also be performed minimally invasively through the side of the chest, via video-assisted thoracoscopy (VATS). The surgeon creates two or three small (¾-inch) incisions. Small surgical instruments and as a camera for viewing the procedure are inserted through the incisions. Surgery takes place entirely inside the closed chest. Benefits include reduced recovery time and less postoperative pain than the open approach. This is the most cosmetically appealing of thymectomy procedures due to the location and the small size of the incisions.
