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Back so soon?

Realtor returns to work within a week of innovative procedure
Joel Maixner was back selling real estate the same week he had his thymus removed at Medcenter One.
Joel Maixner was back selling real estate the same week he had his thymus removed at Sanford Health.
  When Joel Maixner first heard he had a tumor on his thymus, he envisioned something terrible.

“I had a picture of a tumor with little octopus arms wrapping around my heart or something,” the Bismarck real estate agent said. “I wanted to get that thing out of there.”

Maixner got his wish, and, thanks to the latest innovation at Sanford Health, he missed less than a week of work—a vitally important point for a Realtor. The trouble for Maixner began when he started having blurred vision. When one eye shut—and remained closed— for no apparent reason, Maixner visited a neurologist.

He learned he had myasthenia gravis, an autoimmune disorder that causes fatigue and exhaustion of muscles. It happens because the

body produces antibodies that block muscle cells from receiving messages from nerve cells. It can affect the muscles around the eye and impair vision.

A chest X-ray showed a tumor on Maixner’s thymus—an organ located in the upper chest between the breastbone and the heart that plays a role in developing cells of the immune system early in people’s lives but is not vital for adults. These tumors, known as thymomas, are present in about 10 percent to 15 percent of patients with myasthenia gravis. The tumor was pressing on Maixner’s thymus, helping lead to the symptoms he was experiencing.

“It was producing antibodies that attack the nervous system,” said Dr. Timothy Pansegrau, a Sanford Health heart and lung surgeon.

The thymus and the attached tumor needed to come out.

Maixner researched his options and decided he wanted a minimally invasive procedure if possible to remove his thymus. He read about Sanford Health’s da Vinci Surgical System and visited Dr. Pansegrau to see if he would be a candidate for the robotic-assisted method of surgery.

Robotic-assisted surgery allows surgeons to access the well-protected organs in the chest cavity through tiny incisions in the cartilage between the ribs rather than splitting the breastbone to spread the rib cage. This minimally invasive method reduces pain, blood loss and recovery time, Dr. Pansegrau said.

  Dr. Timothy Pansegrau
Timothy Pansegrau, MD
Cardiovascular surgery

Sanford Health is the first and only health system in Bismarck-Mandan to offer this innovative technology. The surgeon has control over the robotic system, which translates his or her hand movements into smaller, more precise movements of tiny instruments that enter the body through minor incisions. The instruments mimic—and, at times, exceed—the complex movements of the human hand and wrist.

Maixner proved to be a good candidate for the method, and Dr. Pansegrau used robotic-assisted surgery to remove Maixner’s thymus. It was the first thymus removal using the da Vinci in North Dakota and required only four small incisions in Maixner’s chest.

“I certainly didn’t want to have my chest open if it wasn’t necessary,” Maixner said.

Typically, patients who have to have their chest cavity opened during surgery need two months to recover and resume normal activities, Dr. Pansegrau said. Because his procedure was performed in a minimally invasive fashion, Maixner, whose surgery took place on a Monday, managed to return to work that same Friday after a two-night hospital stay.

“It’s nice when the patients can get back to their daily routines so much quicker,” Dr. Pansegrau said. “It’s taken a major operation and greatly reduced the recovery time.”

Following the procedure, Maixner learned the tumor on his thymus was benign, or non-cancerous. He has returned to his normal work schedule, and the symptoms from his myasthenia gravis are far less severe now that his thymus is out.

He’s thankful the robotic-assisted surgical technology and a highly trained and skilled surgeon such as Dr. Pansegrau are available in Bismarck.

Click here for more information about Sanford Health cardiology or call (701) 323-5202.


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