38% increase in thymoma patients over 14 years Robotic surgery minimizes pain and sequelae
Oct 07, 2024
Kim, a woman in her 50s, was very surprised to receive the results of a chest CT taken at a medical examination in June.
It was because a tumor was found in her thymus. Kim, who rushed to see the university hospital, said from the doctor that there is a possibility of a benign tumor, but the tumor must be removed and examined by surgery to confirm whether it is malignant" was told. I was worried about the possibility of cancer, but I was a little relieved to hear that it would be detected relatively early and the treatment results would be good.
The thymus (chest gland) is a butterfly-shaped organ located in the center of the chest and is involved in the production and maturation of immune cells. It is very large because the immune system matures quickly at birth, but after puberty, its function and size degenerate and remain as a trace organ.
Thymoma, the most common tumor that develops in the thymus, is classified as a borderline tumor. It has the characteristics of increasing size and metastasis like cancer, and can be confirmed through biopsy after resection. Since the thymus is an organ that does not function in our body after puberty, removing the thymus due to thymoma does not significantly interfere with daily life.Because nerves are not distributed around the thymus, symptoms such as pain do not occur well even if thymoma occurs. Therefore, chest CT scans often accidentally detect thymoma during health checkups, and as chest health checkups have increased recently, more and more patients are diagnosed with thymoma.
According to the statistics of thymoma (D15, D38, C37) by the Health Insurance Review and Assessment Service, the number of thymoma patients has risen 38% over the past 14 years from 16,394 in 2010 to 22,644 in 2023. By age, 30 percent of people in their 60s, 22 percent in their 50s, and 18 percent in their 70s were the most common, with people in their 50s and 70s accounting for 70 percent of the total.
Recently, minimally incisional surgery through thoracoscopy and robotic surgery has been more used in thoracoscopic surgery than thoracotomy, which opens the chest. In particular, single-hole robotic surgery, which is approached through the lower part of the solar plexus in the center, has a better prognosis, faster recovery, and less aftereffects compared to conventional surgery methods that make holes between ribs (the ribs).
Intercostal nerves that diverge from the spinal cord are located between the ribs. As a result, the surgical method using thoracoscopy, which creates an incision between the ribs, has a high risk of nerve damage during surgery, even though it is a small hole, and there is a problem that the quality of life deteriorates due to pain and discomfort every time you breathe after surgery.
In addition, since the thymus is located in the center of the body, it is difficult to secure the field of view of the opposite surgical site when the surgical instrument approaches through the intercostals. For this reason, there is a possibility of incomplete resection that does not completely remove the tumor, and in some cases, an incision window is made between both ribs to prevent this.
Professor Lee Hee-sung of Cardiovascular Thoracic Surgery at Hallym University's Dongtan Sacred Heart Hospital is performing thoracic adenoma surgery using Da Vinci SP (Single Port), the latest single-hole robotic surgery machine introduced in 2022.
Da Vinci SP, optimized for single-hole surgery, has three surgical instruments and a body insertion tube with one high-definition camera that enters one incision and then splits in various directions at the surgical site. There is no collision between surgical instruments and more sophisticated surgery is possible from various angles, which is advantageous for the preservation of major nerves and blood vessels.
With thoracoscopic surgery, access to the thymus was difficult except between the ribs. However, using Da Vinci SP, which has free joint movement and no possibility of collision between instruments, makes a 3cm incision 2cm below the solar plexus and can be approached while looking at the thymus from the center. Since surgery is possible without shaking hands while viewing three-dimensional images magnified 10 to 15 times that of robotic surgery, damage to other organs or structures is minimized, and tumors can be removed elaborately with single-hole surgery. In addition, since it is not an incision in the muscle, there is little pain or sequelae after surgery, and the recovery period is short.
Professor Lee Hee-sung said "Thymenoma is known as a rare borderline tumor, but caution is required as the number of patients continues to increase."The area around the thymus is difficult to operate because major organs such as the heart and lungs are located, but due to recent advances in medical technology and technology, it can be removed with minimal incision through single-hole robotic surgery.", he explained.
It was because a tumor was found in her thymus. Kim, who rushed to see the university hospital, said from the doctor that there is a possibility of a benign tumor, but the tumor must be removed and examined by surgery to confirm whether it is malignant" was told. I was worried about the possibility of cancer, but I was a little relieved to hear that it would be detected relatively early and the treatment results would be good.
The thymus (chest gland) is a butterfly-shaped organ located in the center of the chest and is involved in the production and maturation of immune cells. It is very large because the immune system matures quickly at birth, but after puberty, its function and size degenerate and remain as a trace organ.
Thymoma, the most common tumor that develops in the thymus, is classified as a borderline tumor. It has the characteristics of increasing size and metastasis like cancer, and can be confirmed through biopsy after resection. Since the thymus is an organ that does not function in our body after puberty, removing the thymus due to thymoma does not significantly interfere with daily life.Because nerves are not distributed around the thymus, symptoms such as pain do not occur well even if thymoma occurs. Therefore, chest CT scans often accidentally detect thymoma during health checkups, and as chest health checkups have increased recently, more and more patients are diagnosed with thymoma.
According to the statistics of thymoma (D15, D38, C37) by the Health Insurance Review and Assessment Service, the number of thymoma patients has risen 38% over the past 14 years from 16,394 in 2010 to 22,644 in 2023. By age, 30 percent of people in their 60s, 22 percent in their 50s, and 18 percent in their 70s were the most common, with people in their 50s and 70s accounting for 70 percent of the total.
Recently, minimally incisional surgery through thoracoscopy and robotic surgery has been more used in thoracoscopic surgery than thoracotomy, which opens the chest. In particular, single-hole robotic surgery, which is approached through the lower part of the solar plexus in the center, has a better prognosis, faster recovery, and less aftereffects compared to conventional surgery methods that make holes between ribs (the ribs).
Intercostal nerves that diverge from the spinal cord are located between the ribs. As a result, the surgical method using thoracoscopy, which creates an incision between the ribs, has a high risk of nerve damage during surgery, even though it is a small hole, and there is a problem that the quality of life deteriorates due to pain and discomfort every time you breathe after surgery.
In addition, since the thymus is located in the center of the body, it is difficult to secure the field of view of the opposite surgical site when the surgical instrument approaches through the intercostals. For this reason, there is a possibility of incomplete resection that does not completely remove the tumor, and in some cases, an incision window is made between both ribs to prevent this.
Professor Lee Hee-sung of Cardiovascular Thoracic Surgery at Hallym University's Dongtan Sacred Heart Hospital is performing thoracic adenoma surgery using Da Vinci SP (Single Port), the latest single-hole robotic surgery machine introduced in 2022.
Da Vinci SP, optimized for single-hole surgery, has three surgical instruments and a body insertion tube with one high-definition camera that enters one incision and then splits in various directions at the surgical site. There is no collision between surgical instruments and more sophisticated surgery is possible from various angles, which is advantageous for the preservation of major nerves and blood vessels.
With thoracoscopic surgery, access to the thymus was difficult except between the ribs. However, using Da Vinci SP, which has free joint movement and no possibility of collision between instruments, makes a 3cm incision 2cm below the solar plexus and can be approached while looking at the thymus from the center. Since surgery is possible without shaking hands while viewing three-dimensional images magnified 10 to 15 times that of robotic surgery, damage to other organs or structures is minimized, and tumors can be removed elaborately with single-hole surgery. In addition, since it is not an incision in the muscle, there is little pain or sequelae after surgery, and the recovery period is short.
Professor Lee Hee-sung said "Thymenoma is known as a rare borderline tumor, but caution is required as the number of patients continues to increase."The area around the thymus is difficult to operate because major organs such as the heart and lungs are located, but due to recent advances in medical technology and technology, it can be removed with minimal incision through single-hole robotic surgery.", he explained.
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