Thymectomy is the surgical removal of the thymus gland, which is located just under the breast bone. It is an effective treatment for people who have myasthenia gravis, a neuromuscular disorder, or thymoma, a tumor of the thymus gland.
A newer method of removing the thymus is robotic surgery, using the daVinci Robotic System.
This technology gives your surgeon much better access to the thymus and more precise control, while shortening your recovery time. Swedish is one of the few medical centers in the Northwest to offer robotic thymectomy.
In the videos below, Dr. Brian Louie describes the robotic thymectomy procedure and its benefits.
Robotic thymectomy is done in an operating room with a specially trained support staff. Patients are under general anesthesia, and constantly monitored by an anesthesiologist.
During the procedure:
- The surgeon makes three tiny incisions – each about a half-inch long – on one side of the patient’s chest
- A tiny camera and specially designed surgical instruments are inserted through the incisions
- The arms of the daVinci robot are then attached to the instruments
- The surgeon sits at a nearby console, controlling every movement of the robotic arms
- The surgeon carefully separates the thymus gland from surrounding structures and removes it through one of the incisions
Once the procedure is complete, the surgical instruments are removed, and the small incisions sutured closed.
With a traditional thymectomy, an open procedure called a sternotomy is done to give the surgeon access to the thymus. A sternotomy involves making a long incision in the chest, and then splitting open the breast bone.
A sternotomy is a major surgery, requiring three to five days in the hospital, and up to six weeks to recover.
Robotic thymectomy is much less invasive. Because there is no long incision and the chest does not have to be opened, patients experience:
- A shorter hospital stay – usually going home the day after surgery
- Less pain – typically requiring only mild pain medications
- A quick recovery – taking about two weeks to get back to work
Research done by Swedish thoracic surgeons confirms these benefits. Other research done by thoracic surgeons at Swedish has examined the use of near-infrared fluorescence imaging during robotic thymectomy.
Read more about robotic thymectomy and patient benefits of this procedure.
You may have heard about VATS (Visually Assisted Thoracic Surgery) for lung surgery. VATS is also less invasive than open surgery, and also involves operating through small incisions in the chest.
With VATS, surgeons insert rigid-handled instruments through the incisions, and view the surgery on a flat-screen monitor.
In comparison, robotic surgery uses extremely flexible instruments, which can mimic the movement of the human wrist – without any tremor. Surgeons are able to operate more easily and intuitively.
They also view the surgical area up close through a magnified system that shows everything in three dimensions.
Surgeons at Swedish – who also pioneered VATS procedures in the Northwest – believe advantages of robotic surgery over VATS include:
- The greatly improved surgical instruments
- Significantly better visibility of vital structures, such as pulmonary arteries
- The ability to perform precise movements and dissection more easily
All of these advantages give the surgeon better control – which further reduces the risk of complications for patients.
All surgeries involve some degree of risk, and discussing this with your doctor is an important part of preparing for any surgery.
The potential complications for all methods of thymectomy are the same: the heart, lungs, and major arteries all occupy the same space as the thymus gland. Surgeons take care to avoid trauma to them.
Less than one percent of all of the robotic thymectomies performed at Swedish have had any complications.
Robotic surgical systems are now widely available, but that does not mean every surgeon is qualified to perform robotic surgery.
Thoracic robotic surgery, in particular, is a fairly recent advancement – one that requires both skill and experience to be done right.
When you interview surgeons you are considering, be sure to ask:
- How much robotic surgery experience do they have?
- How many robotic thoracic thymectomies have they performed?
- How long has robotic surgery been available at the hospital?
- How many robotic thymectomies have been performed there?
Swedish is a regional center for performing – and teaching – robotic surgery. More than 4,000 robotic procedures have been performed here and everyone on our robotic surgery teams is specially trained and highly experienced.
Our thoracic surgeons are among the most experienced in the country in performing robotic thymectomies.
They were pioneers in VATS surgery, and the first in Seattle to perform robotic thoracic surgery. They have presented their data nationally, and teach robotic techniques to surgeons from around the country.