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

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.