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Definition

A thymectomy is surgery to remove the thymus gland. This gland is located in the upper portion of the chest, behind the sternum (breastbone).

Thymus Gland

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Reasons for Procedure

The thymus gland helps control immune cell growth. It is usually very active when you are an infant, but its function tapers off as you get older. The thymus acts abnormally when a person has myasthenia gravis]]>. This is a disease characterized by weakness of skeletal muscles of the body. This happens because the body's immune system attacks the area where the nerves attach to the muscles. Thymectomy is used to treat myasthenia gravis.

A thymectomy may also be done if the thymus has a tumor.

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Possible Complications

Complications are rare, but no procedure is completely free of risk. If you are planning to have a thymectomy, your doctor will review a list of possible complications, which may include:

  • Bleeding
  • Infection
  • Damage to other organs
  • Nerve injury
  • Respiratory failure

If you are age 60 or older, you are at increased risk of complications.

What to Expect

Prior to Procedure

  • Your doctor will likely do the following:
    • X-rays]]>—a test that uses radiation to take a picture of structures inside the body
    • Blood tests
    • Urine tests
    • Muscle strength tests
    • Breathing tests
  • Follow a special diet, which may include withholding foods and fluids before surgery.
  • Take prescribed medicines.
  • Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
  • Arrange to have someone drive you to and from the procedure. Ask for help at home after your procedure.

Anesthesia

]]>General]]> anesthesia will be given. You will be asleep.

Description of Procedure

There are three common methods:

  • Transsternal 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.

Immediately After Procedure

You will be taken to a recovery room. There you will be monitored for any complications.

How Long Will It Take?

About 1-3 hours

How Much Will It Hurt?

Anesthesia will block the pain during the surgery. You may feel some pain as the anesthesia wears off. Your doctor will give you medicine to help manage the pain.

Average Hospital Stay

The usual length of stay is 1-3 days. Your doctor may choose to keep you longer if complications arise.

Post-procedure Care

At the Hospital

You will be given fluids and medicine via an IV line. 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.

At Home

The recovery time varies from patient to patient, depending on the surgical approach. It may take as little as 1-2 weeks or as long as three months before you can return to work or school. Be sure to 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 medicines.

Call Your Doctor

After you leave the hospital, contact your doctor if any of the following occurs:

  • 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 medicines you have been given
  • Cough, difficulty breathing, or chest pain
  • Pain, burning, urgency, or frequency of urination, or persistent bleeding in the urine
  • Persistent nausea and/or vomiting
  • Pain and/or swelling in your feet, calves, or legs
  • Any other worrisome symptoms
In case of an emergency, CALL 911.