There are a number of surgical approaches to the removal of the thymus gland: transsternal (through the breast bone), transcervical (through a small neck incision), transthoracic (through one or both sides of the chest.)
- The transsternal approach is most common and uses the same length-wise incision through the sternum (breast bone)used for most open-heart surgery. It is espoused by surgeons such as Alfred Jaretzki and is the most commonly performed procedure due to its relative simplicity.
- The transcervical approach is a less invasive procedure that allows for removal of the entire thymus gland through a small neck incision. It has been popularized by Joel Cooper. Because of its increased technical demands, it is performed by only a relative few surgeons in North America: Joel Cooper (University of Pennsylvania; Philadelphia, Pennsylvania), M. Blair Marshall (Georgetown University; Washington, DC), Bryan Meyers (Washington University; St. Louis, Missouri), Stephen Cassivi (Mayo Clinic; Rochester, Minnesota), Sudhir Sundaresan (University of Ottawa; Ottawa, Canada), Shaf Keshavjee (University of Toronto; Toronto, Canada), Michael Rutter (Cincinnati Childrens Hospital, Ohio)
Interestingly, there has been no difference in success in symptom improvement between the transsternal approach and the minimally invasive transcervical approach.
Video assisted approaches have been described.
Read more about this topic: Thymectomy
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