Myasthenia Gravis (MG) is a rare autoimmune condition which presents with weakness of muscles of the human body. In a normal person, the brain sends signals via nerves to the neuro-muscular junction (NMJ) located at the interface between nerve and muscle, which then allows the muscle to carry out its action. In MG, the body develops antibodies to this NMJ which prevents muscles from carrying out the intended muscle function, causing the affected person to have drooping of eyelids, blurring of vision, difficulty in walking etc. In a worst-case scenario, this condition can affect the human diaphragm, causing a life-threatening situation where the person is unable to breathe. Some famous Indian personalities who had MG are actors Amitabh Bachchan and the late Arun Bali.
The treatment of MG is mainly done by neurologists via medicines and filtering of plasma (known as plasmapheresis). However, in intractable conditions, not responding to medicines or when patients cannot tolerate the side effects of these medicines, surgery is offered in the form of ‘thymectomy’. Thymectomy is the removal of the thymus gland, which is located just above the heart in the chest region. This is done because thymus is the main production house of the antibodies to the NMJ. This surgery is a difficult and rare procedure that needs skilful surgery and dynamic peri-operative anaesthesia.
This surgery was successfully carried out via VATS (Video Assisted Thoracic Surgery) technique on November 22, 2024 by the Department of Surgical Oncology in CSSB block of Sir Sunderlal Hospital, BHU Varanasi. VATS is the term used for “Minimally Invasive surgery” of the chest region which is similar to ‘laparoscopy’ done for abdominal surgeries. The patient had a speedy recovery due to this VATS technique which avoids long surgical wounds, minimising pain and shortening the duration of hospital stay. This was possible due to excellent teamwork amongst departments of Surgical Oncology, Anaesthesia, Neurology, Nursing, and OT technicians comprising of Dr. Tarun Kumar (Thoracic Cancer Surgeon, Dept of Surgical Oncology), Dr. Nimisha Verma (Consultant Anaesthesiologist), Dr. Shayak Roy (Consultant Anaesthesiologist), Mr. Vinay Jain (Scrub Nurse), Staff Nurse Pratima (OT In-charge), Mr. BB Giri (OT technician) and Mr. Harsh Singh (OT technician). The patient’s treatment before and after surgery was carried out by collaboration with the neurology team under the expertise of Dr. Abhishek Pathak (Consultant Neurophysician, SSH BHU) exemplifying the apical level of superspecialty expertise and inter-departmental medical and surgical care available at SSH and IMS, BHU Varanasi in today’s era.
