Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2016 Sep 7:3:53-63.
doi: 10.2147/RSRR.S93012. eCollection 2016.

Robotic-assisted thymectomy: current perspectives

Giuseppe Marulli  1 , Giovanni M Comacchio  1 , Francesca Stocca  1 , Davide Zampieri  1 , Paola Romanello  1 , Francesca Calabrese  1 , Alessandro Rebusso  1 , Federico Rea  1
Affiliations
Review

Robotic-assisted thymectomy: current perspectives

Giuseppe Marulli et al. Robot Surg. .

Abstract

Thymectomy is the cornerstone in the treatment of thymic tumors and an accepted option for the management of myasthenia gravis. Different surgical approaches have been described, but the gold standard is represented by median sternotomy. In the last two decades, the development of minimally invasive surgery has led to an increased acceptance of thymectomy, especially for benign diseases. Robotic thymectomy seems a further step in the development and evolution of minimally invasive approaches. Since its introduction, different authors described their experience with robotic thymectomy, both for nonthymomatous myasthenia gravis and for thymic tumors. Available data show that robotic thymectomy may be considered a safe and feasible operation. In patients with nonthymomatous myasthenia, robotic thymectomy is effective and the long-term results are encouraging. The role of robotic thymectomy in patients affected by thymoma is still under evaluation, but the intermediate results seem promising both in terms of surgical and oncologic outcomes.

Keywords: myasthenia gravis; robot; thymectomy; thymoma.

PubMed Disclaimer

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Robotic components. Note: (A) surgeon’s console, (B) vision system, and (C) patient-side cart with robotic arms.
Figure 2
Figure 2
Patient and ports positioning. Notes: (A) Patient positioned left-side up at a 30° angle. (B) Ports introduced on the fifth intercostal space on the midaxillary line, fifth intercostal space on the midclavicular space, and third intercostal space on the midaxillary region.
Figure 3
Figure 3
Patient-side cart with robotic arms introduced through the ports.
Figure 4
Figure 4
Resected specimens. Notes: (A) Hyperplastic thymus in patient with MG. (B) Thymus with small thymoma (arrow). Abbreviation: MG, myasthenia gravis.
Figure 5
Figure 5
Chest CT scan (mediastinal window) showing small middle-mediastinal thymoma. Abbreviation: CT, computed tomography.
See this image and copyright information in PMC

References

    1. Rea F, Marulli G, Bortolotti L, Feltracco P, Zuin A, Sartori F. Experience with the “daVinci” robotic system for thymectomy in patients with myasthenia gravis: report of 33 cases. Ann Thorac Surg. 2006;81(2):455–459. - PubMed
    1. Detterbeck FC, Zeeshan A. Thymoma: current diagnosis and treatment. Chin Med J (Engl) 2013;126(11):2186–2191. - PubMed
    1. Balduyck B, Hendriks JM, Lauwers P, Mercelis R, Ten Broecke P, Van Schil P. Quality of life after anterior mediastinal mass resection: a prospective study comparing open with robotic-assisted thoracoscopic resection. Eur J Cardiothorac Surg. 2011;39(4):543–548. - PubMed
    1. Loulmet D, Carpentier A, d’Attellis N, et al. Endoscopic coronary artery bypass grafting with the aid of robotic assisted instruments. J Thorac Cardiovasc Surg. 1999;118(1):4–10. - PubMed
    1. Reichenspurner H, Damiano RJ, Mack M, et al. Use of the voice-controlled and computer-assisted surgical system ZEUS for endoscopic coronary artery bypass grafting. J Thorac Cardiovasc Surg. 1999;118(1):11–16. - PubMed

LinkOut - more resources