Surgical Techniques for Myasthenia Gravis: Robotic-Assisted Thoracoscopic Surgery

Feng Li; Mahmoud Ismail; Aron Elsner; Deniz Uluk; Gero Bauer; Andreas Meisel; Jens-C Rueckert

doi:10.1016/j.thorsurg.2018.12.006

Surgical Techniques for Myasthenia Gravis: Robotic-Assisted Thoracoscopic Surgery

Thorac Surg Clin. 2019 May;29(2):177-186. doi: 10.1016/j.thorsurg.2018.12.006.

Authors

Feng Li¹, Mahmoud Ismail¹, Aron Elsner¹, Deniz Uluk¹, Gero Bauer¹, Andreas Meisel², Jens-C Rueckert³

Affiliations

¹ Department of Surgery, Competence Center of Thoracic Surgery, Charité University Hospital Berlin, Charitéplatz 1, Berlin 10117, Germany.
² Department of Neurology Berlin, Charité University Hospital Berlin, Charitéplatz 1, Berlin 10115, Germany.
³ Department of Surgery, Competence Center of Thoracic Surgery, Charité University Hospital Berlin, Charitéplatz 1, Berlin 10117, Germany. Electronic address: jens-c.rueckert@charite.de.

PMID: 30927999
DOI: 10.1016/j.thorsurg.2018.12.006

Abstract

Robotic-assisted thoracoscopic surgery (RATS) creates an extended approach for thymectomy in terms of locating contralateral phrenic nerve and upper poles of the thymus. RATS thymectomy is indicated in all non-thymomatous myasthenia gravis (MG) patients and thymomatous MG patients with resectable thymoma, typically Masaoka-Koga I and II. Left-sided RATS thymectomy is superior for anatomic reasons and in the special care patients with MG. Up to now, left-sided three-trocar RATS thymectomy is the perfect combination of radical resection and minimal invasiveness among various approaches for thymectomy.

Keywords: Myasthenia gravis; Robotic-assisted thoracoscopic surgery; Thymectomy; Thymoma.

Publication types

Review

MeSH terms

Humans
Myasthenia Gravis / surgery*
Obesity / complications
Patient Positioning
Reoperation
Robotic Surgical Procedures*
Thymectomy / methods*