Thymectomy for Myasthenia Gravis

Myasthenia gravis, a rare autoimmune condition, starts with a small organ in your chest called the thymus. An enlarged or overactive thymus can cause myasthenia gravis. So can a cancerous tumour, such as a thymoma or thymic carcinoma.

How it affects you

When you have myasthenia gravis, your thymus produces immune system proteins called antibodies that mistakenly block signals from the nervous system to the muscles. This interference can cause pain and weakness. In severe cases, symptoms can escalate quickly into a condition known as myasthenic crisis, which may require intensive emergency care.

Why you may want thymus removal for myasthenia gravis

You may already be taking prescription medications to manage symptoms, including high doses of steroids. Removing your thymus with surgery (thymectomy) can help you avoid long-term steroid use, which can cause other health complications.

When you come to Cleveland Clinic London for myasthenia gravis care, we’ll quickly book an evaluation appointment — often within a week or less. During this visit, your neurology consultant will spend time getting to know you and understanding how this condition affects you. They’ll go over your medical history, ask questions about your symptoms and do a physical examination.

 They will consider several factors when deciding if you are a suitable candidate for a thymectomy, including if you:

• Are younger than 50
• Have had moderate to severe myasthenia gravis symptoms for several years
• Have a specific type of myasthenia gravis (AChR antibody positive myasthenia gravis)
• Have mild symptoms affecting how you breathe and swallow
• Take high-dose steroids
• Aren’t getting relief from quick-acting medications, like anticholinesterase drugs
• Have a thymoma

Your surgery consultation

If your neurologist recommends a thymectomy, they will refer you to one of our experienced thoracic surgeons. Both consultants will work together to plan the next steps of your care. They may suggest added treatments before surgery to stabilise severe symptoms and help improve your breathing. Pre-surgery treatments may include:

• Immunoglobulin through a vein in your arm (intravenous)
• Plasma exchange

Once we book your thymectomy, our team will walk you through what to expect from the procedure and recovery. We’re here to answer your questions and help you have the smoothest possible experience.

You’ll have surgery in one of our high-tech operating theatres equipped with the latest tools. We can typically do a thymectomy even if you have unstable symptoms and are on a ventilator.

Whenever possible, our skilled thoracic surgeons will use minimally invasive chest surgery (thoracoscopic surgery) to remove your thymus. They may do this manually or by using an exceptionally precise robotic surgery system. Both kinds of minimally invasive surgery:

• Avoid large incisions, using small “keyhole” cuts instead
• Are gentler on your body and surrounding tissues
• Minimise visible scarring on your chest
• Have a shorter recovery period

In-hospital recovery

You’ll start your recovery in our neuro-intensive therapy unit — one of only a few of its kind in the U.K. Here, you’ll receive 24/7 care from consultants and nurses who specialise in neurological conditions. Our team will keep a close eye on your incisions to make sure they are healing as expected. They will also help you manage any myasthenia gravis symptoms.

Follow-up care

After surgery, your myasthenia gravis symptoms may temporarily worsen before they get better. We carefully track your progress through regular follow-up visits and testing. We can adjust your medication dosages as needed.

How Do I Pay for My Thymus Removal Surgery?

Cleveland Clinic London accepts self-pay or private medical insurance as payment options. If you want to pay in instalments, our partner Chrysalis Finance is here to help you personalise a payment plan to spread out the cost of your care.

Our self-pay specialists are here to help answer all your questions. If you need to find a consultant, we can connect you. And once you’ve had an initial evaluation, our experienced self-pay specialists will provide a personalised estimate for your thymectomy, using the most transparent pricing possible. Then, we’ll schedule your surgery when it’s convenient for you.

What’s Next?

If you’re wondering if thymus removal is best for you, Cleveland Clinic London’s expert consultants can help you find out. We take the time to learn about your condition, your medical history and answer your questions. And we work together to customise your treatment plan. Moving quickly, we book your evaluations and surgery to fit into your busy schedule, allowing you to keep moving ahead with your life.