# Robot-assisted extended thymectomy in juvenile myasthenia gravis: first case performed in Ecuador

## TL;DR

This paper reports the first robot-assisted thymectomy for juvenile myasthenia gravis in Ecuador, showing successful clinical improvement.

## Contribution

The first reported case of robot-assisted extended thymectomy for juvenile myasthenia gravis in Ecuador.

## Key findings

- The surgery was uneventful and resulted in marked clinical improvement.
- There was no recurrence of myasthenic crises during follow-up.
- Advanced surgical techniques can be feasible in low-resource settings.

## Abstract

Myasthenia gravis (MG) is a chronic autoimmune disorder characterized by fatigable muscle weakness, typically caused by antibodies against acetylcholine receptors (AChR) or muscle-specific kinas. While it primarily affects adults, juvenile cases represent a significant minority and often pose greater therapeutic challenges. Extended thymectomy has proven beneficial in AChR-positive MG, reducing symptoms and immunosuppressive needs. Robotic-assisted thymectomy offers enhanced precision with lower morbidity. We report the first such procedure in Ecuador, performed on a 21-year-old woman with recurrent myasthenic crises. The surgery was uneventful, and follow-up showed marked clinical improvement without recurrence, highlighting the feasibility of advanced techniques in low-resource settings.