Myasthenia Gravis is an autoimmune neuromuscular disorder. For details, click on this link to the National Institute of Health on Myasthenia Gravis.

Many children with significant symptoms from myasthenia gravis benefit from thymectomy. The best approach has yet to be determined, but many authors now feel that thoracoscopic removal has the best risk:benefit ratio.

Thoracoscopic thymectomy is a minimally invasive surgical approach to removal of the thymus. The thymus is a highly specialized structure which is important prenatally. After birth, its importance diminishes, and the thymus eventually undergoes significant involution (decrease in size and function). In patients with myasthenia gravis, some patients with autoimmune myastinia gravis will have a easier control of their symptoms if the thymus is removed.

The prior method of removal involved cutting the sternum and removing the thymus through a very large incision on the front of the chest. Thoracoscopic thymectomy is done through 3 small (less than 1″) incisions on either the left or right side (depending on surgeon preference). A small tube or drain is often left in the chest on 1 day to help remove any air or fluid that remains. The patient typically goes home in 2 or 3 days if their myasthenia is well controlled.

There are risks involved in the surgery, including bleeding, damage to the nerve to the diaphragm, damage to the heart, or other complications. Be sure to discuss these with your surgeon. Also, make sure your surgeon has experience with this procedure.

Thoracoscopic Thymectomy in children. Kelly A. Kogut, Anthony J. Bufo, Steven S. Rothenberg, Thom E Lobe. Pediatric Endosurgery & Innovative Techniques. June 2001, 5(2): 113-115. doi:10.1089/10926410152403039.