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机器人经腋气腔入路甲状腺切除术治疗甲状腺肿女童。

Robotic transaxillary thyroidectomy with gasless approach in a girl with goitre.

机构信息

Department of Surgery, Endocrine and Oncological Surgery Division, Tulane University School of Medicine, New Orleans, LA 70112, USA.

出版信息

Int J Med Robot. 2012 Jun;8(2):210-4. doi: 10.1002/rcs.455. Epub 2012 Mar 27.

Abstract

BACKGROUND

Robotic-assisted transaxillary thyroidectomy is a minimally invasive approach for the removal of the thyroid through the axilla. This technique eliminates a visible scar and affords excellent optics of the cervical anatomy. We sought to describe the technique and outcome for transaxillary gasless subtotal thyroidectomy in the paediatric population.

METHODS

A 13 year-old female with an enlarged goitre underwent a transaxillary robot-assisted gasless subtotal thyroidectomy in an academic institution. The main outcome measures were feasibility of the robotic approach, patient and gland characteristics, operative time and complications.

RESULTS

There was no conversion to laparoscopic or open surgery. The robotic docking time was 110 min and total operative time was 150 min. The patient tolerated the procedure well. Estimated blood loss was 10 ml. The patient was discharged within 24 h. There were no perioperative or postoperative complications. In addition there was no evidence of postoperative vocal cord palsy or paresis.

CONCLUSIONS

This initial experience demonstrates that this technique can be a feasible, safe and effective method for subtotal thyroidectomy in the paediatric population. The use of robotic technology for endoscopic thyroid surgery could overcome the limitations of conventional endoscopic surgeries in the surgical management of thyroid disease.

摘要

背景

机器人辅助经腋窝甲状腺切除术是一种通过腋窝切除甲状腺的微创方法。该技术消除了可见的疤痕,并提供了出色的颈部解剖学视野。我们旨在描述经腋窝非气腹小全甲状腺切除术在儿科人群中的技术和结果。

方法

在一所学术机构中,一名 13 岁女性因甲状腺肿大接受了经腋窝机器人辅助非气腹小全甲状腺切除术。主要的观察指标是机器人手术方法的可行性、患者和腺体特征、手术时间和并发症。

结果

无转换为腹腔镜或开放性手术。机器人对接时间为 110 分钟,总手术时间为 150 分钟。患者耐受良好。估计失血量为 10 毫升。患者在 24 小时内出院。无围手术期或术后并发症。此外,无术后声带麻痹或瘫痪的证据。

结论

这一初步经验表明,该技术可作为儿科人群小全甲状腺切除术的一种可行、安全且有效的方法。机器人技术在内镜甲状腺手术中的应用可以克服传统内镜手术在甲状腺疾病治疗中的局限性。

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