VATS stands for Video-Assisted Thoracoscopic Surgery in VATS Thymectomy. With the aid of this minimally invasive surgical procedure, small incisions are made on the right side of the chest instead of splitting the sternum as done in the total Thymectomy. VATS Thymectomy is used to manage conditions like Non-thymomatous Myasthenia Gravis, in conjunction with medical treatment. It helps in faster recovery, causes less pain, and is superior cosmetically due to smaller incisions involved. It also preserves better lung function in the early phase after the surgery.
What is myasthenia gravis?
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Myasthenia Gravis is a chronic neuromuscular autoimmune disease that causes skeletal muscles to become weak. This muscular weakness worsens after activity and improves upon resting. Muscles that control movements like facial expressions, movement of the eye, chewing, swallowing, talking, limb, and neck movements for breathing, etc. are affected. This disorder results from an erroneous transmission of nerve impulses to muscles. It cannot be completely cured but symptoms can only be managed by therapies for improving the quality of life of the patient.
VATS Thymectomy can be employed for both Non-thymomatous Myasthenia Gravis and Thymoma.
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VATS Thymectomy is an effective, time-sparing, minimally invasive, and well-tolerated procedure, with fewer complications when compared to the conventional open procedure. It may be appropriate for both, Non-thymomatous Myasthenia Gravis and early-stage thymoma.
VATS Thymectomy demands a newer set of manual surgical skills as compared to conventional open surgery. But for those experienced in open surgery, the learning curve is steep.
Which gland is removed in the VATS Thymectomy?
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The thymus is an organ that is immunogenic in nature and believed to be responsible for the generation and origin of pathogenic autoantibodies that cause Myasthenia Gravis. Thymic abnormalities are commonly seen in patients with Myasthenia Gravis. Thymectomy aims to remove thymic tissue to manage symptoms of the disease.
What advantages does the VATS approach have over the transcervical approach to Thymectomy?
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There are two minimally invasive approaches to Thymectomy: the VATS approach, and the transcervical approach. Both cause minimal trauma to the chest wall, low morbidity post the procedure, shorter stays at the hospital, and improved patient acceptance of surgery. However, there are some generally accepted advantages that the VATS approach has over the transcervical approach to Thymectomy. Firstly, VATS offers a wider panoramic view of the thorax and ample room for dissection, whereas a transcervical approach, due to having a single incision, is prone to crowding of instruments. Secondly, complications like bleeding are easier to control in the VATS approach than in the transcervical approach to Thymectomy. Thirdly, a wide, magnified operative field is provided by video assistance in the VATS approach allowing the entire surgical team to appreciate the progress of the procedure.
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