ST. LUKE'S-ROOSEVELT SURGEONS USE ROBOTICS IN TREATMENT OF MYASTHENIA GRAVIS

First Documented Case in the World to Remove Thymus Gland

New York, NY - In yet another breakthrough application of robotic surgical technology, physicians at St. Luke's-Roosevelt Hospital Center successfully removed the thymus gland of a 28-year-old patient recently diagnosed with myasthenia gravis.

Cardiothoracic surgeons Robert Ashton, MD, and Joseph DeRose, MD, performed the first totally endoscopic robotic thymectomy - removal of the thymus gland - documented in the world using the Da Vinci Surgical System, manufactured by Intuitive Surgical, Inc. Da Vinci, which is FDA-approved for this type of procedure, is used in surgical programs worldwide. The physicians are presently preparing a paper on the case (performed March 12, 2002) for publication in a leading professional surgical journal.

Myasthenia gravis, an autoimmune disorder, affects approximately 36,000 individuals nationwide. The course of the disease is variable, but usually progressive. Initially, myasthenia gravis manifests as a weakness in the oropharyngeal and limb muscles over an approximate two-year period. As the disease worsens, patientsexperience severe fatigue, intercurrent secondary illnesses and, in the most severe cases, atrophy and death. Complicating factors include stress, viral and/or respiratory illnesses, thyroid disease, pregnancy, menstruation, fevers and certain neuromuscular medications.

Abnormalities in the thymus gland -- located directly behind the breastbone -- are clearly associated with myasthenia gravis. The thymus is the body's central organ for immunological self-tolerance, where B-cells interact with helper T-cells to produce antibodies. Thymectomy - or removal of the thymus gland - is recommended for many individuals with myasthenia gravis, particularly young people early in the course of their disease, though improvement from surgery can occur even after 30 years of symptoms.

How Robotic Technology Works
The Da Vinci Surgical System consists of two primary components: the surgeon's viewing and control console and the surgical arm units that position and maneuver detachable and interchangeable surgical instruments. These pencil-sized instruments (with tiny, computer-enhanced mechanical wrists) are designed to provide the dexterity of the surgeon's forearm and wrist at the operative site through tiny entry ports of less than one centimeter. This technology enables the surgeon to enter the chest cavity and perform surgery without major incisions or separation of the sternum.

"Prior to the development of robotic technology, patients who opted for a thymectomy for treatment of myasthenia gravis had to endure a grueling surgical procedure and a protracted recovery period," said Dr. Ashton. "Robotics results in significantly less post-operative pain and faster recovery time." Dr. Ashton pointed out
that the patient who underwent the first robotically-assisted thymectomy at the St. Luke's Division of St. Luke's-Roosevelt left the hospital after three days of post-operative care.

Dr. Ashton added: "We hope that this experience will allow more patients, particularly those newly diagnosed with myasthenia gravis, to opt for surgery, knowing that many of the negating factors have been drastically reduced."