Thymectomy Procedures

A thymectomy is an operation to remove the thymus gland, which is an essential part of the immune system. It's usually performed in adults as a response to myasthenia gravis, an autoimmune neuromuscular disease involving weakness of the skeletal, or voluntary, muscles. A person with myasthenia gravis has an abnormal thymus gland. Doctors choose from three thymectomy procedures in treating patients with myasthenia gravis, or thymomas (tumors found in the thymus).

Trans-Sternal Thymectomy

• Also called a sternotomy, this procedure involves an incision made over the breastbone and through the sternum, to expose and then remove the thymus gland. A full sternotomy requires staples or wire to close it, and is the most invasive thymectomy procedure. A chest tube is required during recuperation. A partial sternotomy is not quite as invasive as a full sternotomy, as the incision made is smaller; therefore it may involve a shorter recuperation period, leave a smaller scar and possibly not require usage of a chest tube.

Trans-Cervical Thymectomy

• Here a doctor makes a small incision across the lower part of the neck, and uses a scope to find and remove the thymus gland. After it is closed, the doctor leaves a drain inserted for a day or slightly longer. According to the University of Maryland Medical Center, this procedure involves the least pain during recovery and the shortest recovery time.

Thoracoscopic Thymectomy

• In this approach, a doctor creates two to three small incisions on the side of the chest and guides a small telescope (or tiny camera) into an incision. Next dissecting instruments are used, with the telescopic or video images as a guide, to remove the thymus gland. Occasionally a robot arm may be used to complete this procedure. This approach leaves the fewest scars because of the size and placement of the incisions.