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Mammana et al. Mini-invasive Surg 2020;4:37 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2020.24

Review Open Access

Robotic thymectomy for myasthenia gravis

Marco Mammana, Giovanni M. Comacchio, Andrea Dell’Amore, Eleonora Faccioli, Elisa De Franceschi,
Sara Rossi, Federico Rea
Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua
35128, Italy.
Correspondence to: Dr. Marco Mammana, Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and
Public Health, University of Padua, Via Giustiniani, 2, Padua 35128, Italy. E-mail: marcomammana87@gmail.com
How to cite this article: Mammana M, Comacchio GM, Dell’Amore A, Faccioli E, De Franceschi E, Rossi S, Rea F. Robotic
thymectomy for myasthenia gravis. Mini-invasive Surg 2020;4:37. http://dx.doi.org/10.20517/2574-1225.2020.24

Received: 21 Feb 2020 First Decision: 20 Apr 2020 Revised: 21 Apr 2020 Accepted: 12 May 2020 Published: 18 Jun 2020

Science Editor: Piergiorgio Solli Copy Editor: Jing-Wen Zhang Production Editor: Jing Yu

Abstract
Thymectomy is an effective treatment option for the management of myasthenia gravis, as demonstrated by a
recent multicenter randomized clinical trial. Complete removal of all thymic tissue, including ectopic foci, increases
the chance of achieving a remission or a substantial improvement of the disease; therefore, extended transsternal
thymectomy was long considered the procedure of choice. Over the years, several minimally invasive approaches
have been proposed, with the aim to reduce perioperative morbidity and to improve aesthetics; however, concerns
exist that through such approaches, it may not be possible to achieve a complete resection. Robotic thymectomy
seems to overcome many of the limitations associated with other minimally invasive approaches. The available
evidence suggests that robotic thymectomy for myasthenia gravis is a safe procedure, and that long-term
neurological outcomes are satisfactory.

Keywords: Thymectomy, robot, myasthenia gravis

INTRODUCTION
Myasthenia gravis (MG) is a neuromuscular disease that manifests with fluctuating and fatigable weakness
of different muscle groups. It occurs because of the production of autoantibodies directed against the
[1]
components of the neuromuscular junction . The medical management of MG includes the use of
symptomatic therapy (anticholinesterase) and immunosuppressive treatment.

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
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