Agrawal Vikesh, Acharya Himanshu, Agarwal Pawan, Sekhon Virender, Sharma Dhananjaya
Department of Pediatric Surgery, Netaji Subhash Chandra Bose Medical College, Jabalpur, India.
Asian J Endosc Surg. 2013 Aug;6(3):241-4. doi: 10.1111/ases.12031.
External angular dermoid cysts are benign lesions that are excised through an incision over the eyebrow. This leaves a visible scar that may not be cosmetically acceptable. Herein, we describe a minimally invasive subcutaneoscopic technique that involves placing incisions above the hairline to avoid scarring on the face.
This is a retrospective review of three consecutive cases of dermoid cysts. Each patient underwent subcutaneoscopic excision between March 2012 and September 2012. With the patient under general anesthesia, a 6-mm incision was made on the scalp above the hairline. After a wide subcutaneous tunnel was created, a 5-mm port with a 30° telescope was placed for an optical port. Insufflation was done with CO2 at pressure of 8 mmHg and flow rate of 1 L/min. Two para-optical stab incisions were used to insert a 3-mm Maryland dissector and a 3-mm hook for dissection. The cyst was excised and removed through one of the ports.
All three cases underwent successful subcutaneoscopic excision without the need for conversion. The mean operative time was 42 min. There were no complications, and all patients had excellent cosmesis. Subcutaneoscopic excision of dermoid cyst is a technically feasible procedure in pediatric patients, as demonstrated by our three cases. It provides excellent cosmesis and avoids scarring on the face.
外侧角皮样囊肿是良性病变，通过眉部上方的切口进行切除。这会留下明显的疤痕，在美容方面可能无法接受。在此，我们描述一种微创皮下内镜技术，该技术涉及在发际线以上做切口以避免面部留疤。
这是对三例连续的皮样囊肿病例的回顾性研究。每位患者于2012年3月至2012年9月期间接受皮下内镜切除手术。患者在全身麻醉下，于发际线以上的头皮做一个6毫米的切口。在创建一个宽阔的皮下隧道后，置入一个带有30°望远镜的5毫米端口作为光学端口。以8毫米汞柱的压力和1升/分钟的流速用二氧化碳进行气腹。通过两个辅助光学戳孔切口插入一个3毫米的马里兰解剖器和一个3毫米的钩子进行解剖。囊肿通过其中一个端口切除并取出。
所有三例均成功接受皮下内镜切除，无需中转。平均手术时间为42分钟。无并发症发生，所有患者的美容效果均极佳。如我们的三例所示，皮下内镜切除皮样囊肿在儿科患者中是一种技术上可行的手术。它提供了极佳的美容效果并避免了面部留疤。
