Asao Takayuki, Kuwano Hiroyuki, Yamaguchi Satoru, Uchida Nobuyuki, Yanagita Yasuhiro
Department of General Surgical Science, Gunma University, Graduate School of Medicine, Maebashi, Japan.
Surg Laparosc Endosc Percutan Tech. 2005 Dec;15(6):339-44. doi: 10.1097/01.sle.0000191628.81752.18.
A total videoscopic operation with constant CO(2) gas insufflation is ideal for performing a scarless thyroidectomy because the skin incisions at the surgical ports are made far from the neck in the axillar area. However, there are many difficulties associated with the performance of a videoscopic thyroidectomy when approaching pneumo-subcutaneously from distant ports, because the instruments are inserted tangentially toward the thyroid gland from a distant port and their range of manipulation is limited. The devices and surgical techniques used for a videoscopic thyroidectomy that does not leave a scar on the anterior chest or neck were developed. Fine needle-type cautery and forceps that could access directly to the thyroid gland from the neck were used to support the forceps. A CO(2) reservoir bag connected to the CO(2) insufflation tube contributed to the safer manipulation by the creation of a stable operation space during emitting smoke from coagulation device. A silicon ring stopper was useful to prevent dislodging of the ports. In conclusion, videoscopic neck surgery would be easier using these new devices and techniques and would produce better cosmetic results than video-assisted and conventional neck surgeries.
持续进行二氧化碳气体注入的全腔镜手术是实施无痕甲状腺切除术的理想方法，因为手术切口位于腋窝区域，远离颈部。然而，当从远处切口进行皮下充气来实施腔镜甲状腺切除术时，会遇到许多困难，因为器械是从远处切口沿切线方向插入甲状腺，其操作范围有限。于是开发了用于在前胸或颈部不留疤痕的腔镜甲状腺切除术的设备和手术技术。使用了可从颈部直接进入甲状腺的细针型电灼器和镊子来辅助镊子操作。连接到二氧化碳注入管的二氧化碳储气袋，在凝血装置冒烟时通过创造稳定的手术空间，有助于更安全地操作。硅环塞有助于防止切口移位。总之，使用这些新设备和技术进行腔镜颈部手术会更容易，并且比视频辅助和传统颈部手术产生更好的美容效果。
