The thymus (or sweetbread) is an organ of the lymphatic system. It is located above the heart in the so-called anterior mediastinum. However, it can also extend over the entire neck. The thymus gland consists of two lobes; in newborns, each lobe is approx. 5 cm long and 2 cm wide. The thymus continues to grow slightly until puberty and is then increasingly replaced by non-functional fatty tissue (so-called involution).

The function of the thymus is to transform or mature special white blood cells (so-called T lymphocytes).

However, the thymus can also form tumors, e.g. thymomas. They are much less common in children than in adults and sometimes occur in connection with a certain disease called myasthenia gravis (myasthenia gravis = autoimmune disease caused by antibodies against skeletal muscles). Occasionally they also occur in immunodeficiency syndromes. Thymomas develop from epithelial cells (covering tissue that covers the inner and outer surfaces of the body) or lymphoid cells. In principle, they have the potential to degenerate into malignant tumors. In the case of malignancy, they must be differentiated from malignant lymphomas.

If a thymoma is diagnosed in children, it should be completely removed. In specialized paediatric surgical Clinical Departments, this can now be done by thoracoscopy.

The first contact is usually made through an outpatient information meeting in our pediatric surgery outpatient clinic (see below for contact details). Please bring all existing examination results (e.g. X-ray findings or reports from a specialized paediatrician (haematologist, neurologist or rheumatologist)) to the first outpatient information session

In an initial consultation, in which specialist colleagues from the MHH also take part, the treatment options are presented and your questions are discussed in detail. Cross-sectional imaging (computed tomography or magnetic resonance imaging) enables the thymus size (in cm and ml) and its anatomical position to be reliably calculated. The imaging helps the pediatric surgeon to assess which surgical procedure (open by opening the sternum (sternotomy) or thoracoscopic) is the most suitable for your child.

Minimally invasive removal of the thymus usually via thoracoscopy

In children with myasthenia gravis in particular, the thymus can usually be removed via thoracoscopy so that an opening of the sternum (sternotomy) can be avoided. The pediatric surgeon makes a small incision above the chest (from the right or left) through which a thin tube (trocar) is inserted into the chest. Air is blown into the chest cavity through the trocar and a camera is inserted (thoracoscopy). This can be used to inspect the respective right or left chest and the mediastinum. Two further small (0.3 cm) incisions are then made in the chest wall under visualization and further working channels (trocars) are inserted into the chest. The thymus is explored and the blood vessels supplying it are sealed with an electric hook. Finally, the entire thymus gland is removed. It is first placed in a plastic bag specially designed for this operation while still in the chest and then removed directly via the largest trocar. The incisions in the chest are then closed again.

After the procedure, your child will initially remain in the recovery area, where you will be able to sit up in bed again. You will then be transferred to the normal ward. A few hours after the operation, your child will usually be able to eat again. After an uncomplicated thymectomy, an inpatient stay of 2-4 days in hospital is usually sufficient.

As a rule, you will not be seen again for a follow-up examination by us, but by the colleagues who referred you to us for surgery. However, if you still have questions regarding the operation itself or if we consider an earlier follow-up examination with us to be appropriate in individual cases, you can arrange an outpatient appointment at any time.