A thymectomy is surgery to remove the thymus gland. This gland is located in the upper portion of the chest, behind the breastbone.
Reasons for Procedure
The thymus gland helps immune cell growth. It is usually active when you are an infant, but its function reduces as you get older. The thymus acts abnormally when a person has a condition called myasthenia gravis. A thymectomy is used to treat myasthenia gravis. A thymectomy may also be done if the thymus has a tumor, which is called thymoma. These types of tumors are often associated with myasthenia gravis, but may be associated with other conditions.
Your doctor will likely do the following:
Muscle strength tests
There are 3 common methods:
Trans-sternal approach—an incision will be made in the skin over your breastbone. The breastbone will be pulled apart. The thymus gland will then be exposed and removed. The incision will be closed with stitches or staples.
Transcervical approach—a small incision is made across the lower part of the neck, just above the breastbone. The thymus gland will be removed. The incision will be closed with stitches or staples.
Video-assisted thoracic surgery (VATS) or robot assisted thoracic procedures —This is a less invasive option. Several tiny incisions are made in the area. A tiny camera will be inserted through one of the incisions. The camera will send images to a monitor in the room. Robotic arms may be used to do the surgery. Special tools will be passed through the remaining incisions to remove the thymus. After the thymus is removed, the incisions will be closed with stitches.
You will be taken to a recovery room and monitored for any complications. You will be given fluids and medication through an IV. You will be instructed to practice deep breathing, coughing, and frequent turning. Nurses will measure your muscle strength and breathing ability to determine the effectiveness of the surgery.
During your stay, the hospital staff will take steps to reduce your chance of infection, such as:
Washing their hands
Wearing gloves or masks
Keeping your incisions covered
The recovery time varies from person to person, depending on the surgical approach. It may take as little as 1-2 weeks or as long as 3 months before you can return to work or school. Follow your doctor's instructions.
If the surgery was done for myasthenia gravis:
Improvement in muscle strength may take several months to a few years.
It is important to work with a neurologist during the recovery period to regulate medications.
You may need to work with a physical therapist
Contact your doctor if your recovery is not progressing as expected or you develop complications, such as:
Signs of infection, including fever and chills
Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
Pain that you cannot control with the medications you were given
Cough, difficulty breathing, or chest pain
Pain, burning, urgency, or frequency of urination, or persistent bleeding in the urine
Persistent nausea and vomiting
Pain and/or swelling in your feet, calves, or legs
New or worsening symptoms
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Transsternal thymectomy: In this procedure, the incision is made in the skin over the breastbone (sternum), and the breastbone is divided (sternotomy) to expose the thymus. This approach is commonly used for heart surgery.
The thymus is part of the body's immune system, and plays its largest role early in a person's development. Surgical removal of the thymus has no effect on the immune system for someone after they are born.
If you have a tumor, called a thymoma, doctors will surgically remove your thymus gland (thymectomy). Even if you don't have a tumor in the thymus gland, removing the gland might improve your myasthenia gravis symptoms. However, the benefits of thymectomy can take years to develop.
A person without a thymus does not produce these T cells and, therefore, is at great risk for developing infections. By the time humans reach puberty, the thymus has completed most of its role in the body, shrinks in physical size and becomes dormant.
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