Katz Leah, Abdel Khalek Mohamed, Crawford Byron, Kandil Emad
Endocrine and Oncological Surgery Division, Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA.
Minim Invasive Ther Allied Technol. 2012 May;21(3):201-5. doi: 10.3109/13645706.2011.581291. Epub 2011 May 4.
The advancement of minimally invasive surgical technologies over the past several years has led to improved surgical outcomes and greater patient satisfaction. Particularly for patients undergoing parathyroidectomies, endoscopic surgeries resulted in smaller surgical scars when compared with the open approach. Early endoscopic methods, however, were still restricted in their ability to provide adequate dexterity, two-dimensional views of the operative field; and while smaller than open surgeries, still left the presence of a small cervical scar. The limitations of endoscopic surgery led to application of the da Vinci S surgical robot system (Intuitive Surgical, Sunnyvale, CA, USA) and a novel transaxillary approach for parathyroidectomy. This surgical technique and approach is ideal for patients with primary hyperparathyroidism. This case report demonstrates that parathyroidectomy with en bloc thyroid lobectomy for atypical parathyroid adenomas using robotic- assisted transaxillary surgery is safe and feasible.
在过去几年中，微创外科技术的进步带来了更好的手术效果和更高的患者满意度。特别是对于接受甲状旁腺切除术的患者，与开放手术相比，内镜手术产生的手术疤痕更小。然而，早期的内镜方法在提供足够的灵活性、手术视野的二维视图方面仍受到限制；并且虽然比开放手术小，但仍会留下一个小的颈部疤痕。内镜手术的局限性导致了达芬奇S手术机器人系统（直观外科公司，美国加利福尼亚州桑尼维尔）的应用以及一种新型的经腋窝甲状旁腺切除方法。这种手术技术和方法对于原发性甲状旁腺功能亢进患者来说是理想的。本病例报告表明，使用机器人辅助经腋窝手术对非典型甲状旁腺腺瘤进行整块甲状腺叶切除术的甲状旁腺切除术是安全可行的。
