Department of Otolaryngology, Head and Neck Surgery, Philipp University, Marburg, Germany.
Surg Endosc. 2011 Apr;25(4):995-1003. doi: 10.1007/s00464-010-1341-2. Epub 2010 Sep 16.
There is increasing demand for surgical procedures which avoid visible scars while maintaining optimal functional and ideal cosmetic results, without compromising the safety or effectiveness of the procedure. Endoscopic techniques have been adapted to abdominal and pelvic surgery and increasingly employed over the past three decades. Although hampered by the absence of a natural cavity, endoscopic techniques have been adapted to surgery in the neck for the past 15 years, particularly for the thyroid gland. While earlier attempts at endoscopic thyroid surgery were performed through incisions in or near the midline of the neck, recent techniques have been developed to place the incisions and endoscopic ports extracervically, or at least away from the midline region of the neck, rendering the cosmetic result more acceptable. Most of these approaches are through the axilla, breast, chest wall or a combination of approaches. Visualization of the thyroid and rate of complications with these approaches are equal to those attained with older endoscopic approaches. Careful patient selection is important for endoscopic surgery. Complications unique to the endoscopic approach are mostly related to insufflation of cervical tissues with pressurized CO(2).
人们对手术的需求日益增加，希望手术能够避免可见的疤痕，同时保持最佳的功能和理想的美容效果，且不影响手术的安全性和有效性。过去三十年来，内镜技术已被应用于腹部和盆腔手术，并得到越来越多的应用。尽管受到缺乏自然腔隙的限制，内镜技术在过去 15 年中已被应用于颈部手术，特别是甲状腺手术。虽然早期的内镜甲状腺手术尝试是通过颈部中线或附近的切口进行的，但最近已经开发出将切口和内镜端口置于颈部外或至少远离颈部中线区域的技术，使美容效果更令人满意。这些方法中的大多数是通过腋窝、乳房、胸壁或多种方法联合进行的。这些方法的甲状腺可视化和并发症发生率与传统内镜方法相当。内镜手术的患者选择非常重要。内镜方法特有的并发症主要与颈组织的加压 CO(2)充气有关。
