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A mother of four traveled to Houston from Cairo, Egypt, to undergo robotic removal of the thymus gland at Methodist West Houston Hospital on Thursday, February 7. She was released after a three-day stay and plans to return to Egypt following her final visit with her surgeon.

Cardiothoracic surgeon Dr. Miguel Gomez performed the thymectomy surgery removing Amani Kotb’s thymus gland with the assistance of two robotic arms inserted into the chest cavity through small intercostal (between the ribs) incisions.  Kotb and her husband made the decision to undergo the robotic procedure offered at Methodist West Houston with the hope of reducing her daily dependence on medication to treat myasthenia gravis (MG), a neuromuscular disorder that causes weakness and pain in the voluntary muscles.  For the past 10 years, Kotb had been medically treating her disease but as symptoms worsened, thymectomy surgery became a consideration.

“These past two years I have felt horrible, but I could not risk having my chest opened to take out this gland,” she said. “We have excellent physicians and surgeons at home, but we do not have a robot, so I came here.”

Complete removal of the thymus gland, thymectomy, is an established treatment for moderate to severe MG in patients younger than 60. Thymectomy is believed to improve long-term outcomes for MG patients, with the goal of complete elimination of all symptoms and medication.

“Robotic thymectomy is a safe surgical option with the advantages of less blood loss and reduced recovery time,” Gomez said. “The end result compares favorably with conventional open chest approaches and patients are now often referred to a surgeon soon after a MG diagnosis.” 

The fist-sized thymus gland sits within the protected area of the chest, with finger-like extensions into the neck. With minimally invasive robot technology, surgeons can completely remove the gland without the trauma of opening the chest.

“Patient experiences have been extremely positive,” Gomez said.  “Ms. Kotb is recovering well and is ready to make the trip home as planned.”      

In the United States, it is estimated that one out of every 20,000 individuals has MG. 

AK Thymectomy 2 13
Cardiothoracic surgeon Dr. Miguel Gomez, myasthenia gravis patient Amani Kotb, and
her husband Osama Elnahhas during their post-surgery visit.

Opened in December 2010, Methodist West Houston Hospital is the newest community hospital in The Methodist Hospital System. With capacity for 193 beds, 28 emergency room beds and 15 operating rooms, Methodist West Houston’s specialty care includes cardiology and cardiovascular surgery; orthopedics, sports medicine and rehabilitation; comprehensive cancer care; neurology and neurosurgery;  labor and delivery, level II neonatal intensive care unit,, state-of-the-art imaging; plastic and reconstructive surgery; otolaryngologic, urologic and gastrointestinal surgery and minimally invasive surgery, including robotics.