Profanter C, Schmid T, Prommegger R, Bale R, Sauper T, Bodner J
Department of General and Transplant Surgery, University Hospital Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria.
Surg Endosc. 2004 May;18(5):868-70. doi: 10.1007/s00464-003-4272-3. Epub 2004 Feb 2.
We report the first case of robot-assisted thoracoscopic resection of a mediastinal parathyroid adenoma in the aorto-pulmonary window. Intervention planning was based on preoperative CT-MIBI image fusion, a new imaging modality that enabled reliable and precise localization of the parathyroid. The technique consists of taking MIBI-SPECT and CT separately, using a fixation unit that provides reproducible positioning of the patients head and neck. The data sets are then superimposed upon each other using special software. After the localization process, a minimally invasive operation was performed using the DaVinci operating robot. The procedure proved not only to be feasible but also safe and not time-consuming. The postoperative course was uneventful, and the patient was discharged 4 days postoperatively. Compared to conventional thoracoscopic surgery, the robotic operating system provides better visualization of the operating field and facilitates the movement of the instruments. Precise preoperative imaging enables the careful planning of robot-assisted surgery for ectopic parathyroids located at relatively inaccessible regions such as the anterior mediastinum.
我们报告了首例在主动脉-肺动脉窗行机器人辅助胸腔镜切除纵隔甲状旁腺腺瘤的病例。干预计划基于术前CT-MIBI图像融合，这是一种新的成像方式，能够对甲状旁腺进行可靠且精确的定位。该技术包括分别采集MIBI-SPECT和CT图像，使用一个能对患者头部和颈部进行可重复定位的固定装置。然后使用特殊软件将数据集相互叠加。定位完成后，使用达芬奇手术机器人进行了微创手术。该手术不仅被证明是可行的，而且安全且不耗时。术后过程顺利，患者术后4天出院。与传统胸腔镜手术相比，机器人操作系统能更好地显示手术视野，并便于器械操作。精确的术前成像能够为位于如前纵隔等相对难以到达区域的异位甲状旁腺进行机器人辅助手术的精心规划。
