title: First experience of robotic extended thymectomy in Japan for myasthenia gravis with thymoma.
abstract: We performed robot (da Vinci)-assisted thoracoscopic extended thymectomy (rThx) for myasthenia gravis with thymoma. The patient was a 66-year-old woman who complained of palpebral heaviness. Robotic operation was performed in the supine position by placing four ports in the right chest wall under 10 mmHg CO(2) insufflation using three arms and one assist port. Compared with conventional video-assisted thoracic surgery (VATS), the bilateral upper horns, fat around the diaphragm, and aortopulmonary window could be resected more easily. The tumor measured 41 mm maximum diameter and was diagnosed as type AB noninvasive thymoma. The operating time was 298 min, console operating time was 203 min, and the amount of bleeding was small. The postoperative course was uneventful with no complications. This is a report of the first Japanese case of rThx for myasthenia gravis. rThx is a promising technique, and further improvement in the procedure is expected.
authors.affiliation: Center of Minimally Invasive Surgery, Tottori University Hospital,Yonago, Tottori, Japan. hnaka@med.tottori-u.ac.jp
authors.forename: Hiroshige
authors.initials: H
authors.lastname: Nakamura
authors.forename: Yuji
authors.initials: Y
authors.lastname: Taniguchi
authors.forename: Shinji
authors.initials: S
authors.lastname: Fujioka
authors.forename: Ken
authors.initials: K
authors.lastname: Miwa
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Haruki
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Takagi
authors.forename: Yohei
authors.initials: Y
authors.lastname: Yurugi
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Kubouchi
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007564:Japan; D008279:Magnetic Resonance Imaging; D009157:Myasthenia Gravis / Q000150:complications*; D009375:Neoplasms, Glandular and Epithelial / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D056888:Patient Positioning; D012371:Robotics; D025321:Surgery, Computer-Assisted / Q000009:adverse effects; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects; D013934:Thymectomy / Q000009:adverse effects / Q000379:methods*; D013953:Thymus Neoplasms / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome