Have you ever been told by a doctor about breast surgery? It's normal to feel a little scared and nervous when you hear that. But don't worry. Today we're going to talk about one such surgery, a "thymectomy." Let's simply understand what it is, why it's done, how it's done, and what happens after the surgery.
First of all, what is Thymectomy?
Simply put, a thymectomy is the surgical removal of your thymus gland. The thymus gland is located in the upper chest, just in front of the heart.
This is a very special gland. It helps a lot in developing our immune system when we are young. But as we grow older, this gland shrinks. Sometimes, due to certain problems with this gland, doctors have to remove it. This is not a very common surgery.
What medical conditions lead to this surgery?
There are several main reasons for removing the thymus gland. Let's take a look at what they are.
| Disease status | A simple explanation |
|---|---|
| Myasthenia Gravis | This is a disease involving the nerves and muscles. The main symptom is muscle weakness in the body. These symptoms can be controlled by removing the thymus gland. |
| Thymoma | This is a tumor that develops in the thymus gland. It can be cancerous (thymic carcinoma) or it can be noncancerous (benign). This surgery is done to remove such tumors. |
| Other types of nuts | Other rare types of tumors, such as neuroendocrine tumors, can also develop in the thymus gland. This surgery is a solution for them too. |
How do you prepare before surgery?
If you decide to have a thymectomy, your doctor will examine you carefully and discuss your medical history. In addition, you may be asked to perform several other tests.
- Pulmonary function test: See how well your lungs are working.
- EKG (Electrocardiogram): Learn about the functioning of the heart.
- Cardiac stress test: See how your heart responds to exercise.
- CT scan (Computed Tomography scan) or MRI (Magnetic Resonance Imaging): To clearly see the thymus gland and surrounding organs.
- PET scan (Positron Emission Tomography scan): To check for cancer cells.
Most importantly: If you are taking any medications (especially for Myasthenia Gravis), be sure to ask your doctor if you need to stop them before surgery. Do not stop any medications without his or her advice.
You will usually be advised to stop eating and drinking from midnight the night before surgery.
Let's see how the surgery is done.
There are two main methods for performing a thymectomy. One is through an open procedure, and the other is through a series of small incisions and a camera. Your doctor will decide which method is best for you.
| Surgical method | How it happens |
|---|---|
| Open Surgery (Transsternal Approach) | In this, the chest is opened by cutting the middle bone (sternum) lengthwise, similar to open heart surgery. Then the thymus gland and surrounding tissue are removed. Finally, one or two chest tubes are inserted to drain fluid from the chest cavity, the bone is fixed with wires, and the skin is sewn shut. |
| Minimally Invasive Surgery (Minimally Invasive - Robotic or VATS) | This procedure does not involve making a large incision in the chest. Instead, three small incisions are made on the side of the chest, one with a camera and the other with special instruments. Using these instruments (sometimes with the help of a robotic arm), the gland is removed, placed in a small bag, and taken out through one of the incisions. This procedure is less painful and has less recovery time. |
Typically, this surgery can take about two to four hours.
Benefits and risks of surgery
Benefits of this surgery
This surgery can provide great relief to someone with Myasthenia Gravis.
- The number of hospitalizations due to the disease is decreasing.
- It is possible to reduce the medications you take for the disease (e.g. Prednisone).
- The weakness of the body decreases.
- Some people experience complete relief from symptoms and are able to do without medication.
If the surgery is performed minimally invasively, there is less hospital stay, less blood loss, less pain, and you can return to your normal life sooner.
About 70% of people who undergo thymectomy for myasthenia gravis experience a reduction in symptoms and the need for medication. Between 30% and 40% experience complete resolution of symptoms.
Possible risks (Complications)
As with any surgery, there are some risks involved, but these do not occur in everyone.
- Damage to the heart, a nerve, or a nearby blood vessel.
- Bleeding.
- Pneumothorax.
- Infections such as pneumonia.
- Myasthenic crisis is a rare emergency caused by the stress of surgery.
How long does it take to heal and what to watch out for?
The recovery time depends on whether you had open surgery or minimally invasive surgery. However, you will need to stay in the hospital for at least a day. You will be given medication to control the pain after the surgery, which will usually be completely gone in about two weeks.
The time it takes for you to return to work depends on the nature of your job. If you have a desk job, you can go back to work quickly. However, if you have a job that requires heavy lifting or standing for long periods of time, you may need to take a little longer to recover.
If you have these symptoms, call your doctor immediately.
When you go home after surgery, you should notify your doctor immediately if you experience any of the following symptoms:
- Difficulty breathing.
- Pain on one side of the chest.
- Increased breathing rate.
- Increased heart rate.
- Fever.
- Cough.
- Bleeding or fluid leaking from the surgical incision.
- Myasthenia Gravis symptoms reoccur.
Finally, it's normal to feel scared when you're having surgery. But remember, surgeons do this all the time. They're always trying to give you the best possible outcome. So don't be afraid to ask your doctor any questions or concerns you may have.
Take-Home Message
- Thymectomy is the surgical removal of the thymus gland. It is mainly performed as a treatment for conditions such as Myasthenia Gravis and Thymoma.
- There are two main methods of performing the surgery (open and minimally invasive). Talk to your doctor about which method is best for you.
- The benefits of this surgery for Myasthenia Gravis patients are very high, but it may take some time to see results.
- Recovery after surgery is manageable, and following medical instructions is very important.
- Be aware of the warning signs that may occur after surgery and notify your doctor immediately if you notice any.
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