Park Jun-Ook, Kim Sang-Yeon, Chun Byung-Joon, Joo Young-Hoon, Cho Kwang-Jae, Park Young Hak, Kim Min-Sik, Sun Dong-Il
Department of Otorhinolaryngology-Head and Neck Surgery, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, South Korea.
Surg Endosc. 2015 Jun;29(6):1469-75. doi: 10.1007/s00464-014-3826-x. Epub 2014 Aug 27.
A new approach to modifying facelift incision was recently developed for robotic thyroid surgery that seemed to be advantageous over other existing approaches. In this study, we aimed to investigate the feasibility and safety of the facelift approach not only for robotic thyroid surgery, but also for endoscope-assisted thyroid surgery.
Endoscope-assisted facelift thyroid lobectomy was performed for 11 patients with papillary microcarcinoma.
All 11 operations were successfully performed endoscopically. This approach through a modified facelift incision provided safe dissection of the laryngeal nerves and exposed an adequate working space. We identified and preserved all neighboring critical structures (parathyroid gland and superior and recurrent laryngeal nerves) during surgery. The operative duration for simple thyroid lobectomy with central lymph node dissection in 11 patients was 120-180 min (average duration: 140 min). Sensory change around the earlobe occurred in three patients and was recovered within 2 months after surgery in all patients. No patient displayed laryngeal nerve palsy or a low-pitched voice.
The facelift approach seems to provide a shorter and more direct route to the thyroid, requiring minimal dissection, and an adequate workspace not only for robotic surgery but also for endoscopic surgery. It is worthwhile to develop and refine the surgical techniques of endoscopic facelift thyroid surgery.
最近为机器人甲状腺手术开发了一种改良的面部提升切口方法,该方法似乎比其他现有方法更具优势。在本研究中,我们旨在研究面部提升入路不仅用于机器人甲状腺手术,还用于内镜辅助甲状腺手术的可行性和安全性。
对11例微小乳头状癌患者进行了内镜辅助面部提升甲状腺叶切除术。
所有11例手术均在内镜下成功完成。这种通过改良面部提升切口的方法提供了安全的喉返神经解剖,并暴露了足够的操作空间。我们在手术过程中识别并保留了所有相邻的关键结构(甲状旁腺以及喉上神经和喉返神经)。11例患者行单纯甲状腺叶切除加中央淋巴结清扫的手术时间为120 - 180分钟(平均时长:140分钟)。3例患者出现耳垂周围感觉改变,所有患者均在术后2个月内恢复。无患者出现喉返神经麻痹或声音低沉。
面部提升入路似乎为甲状腺提供了一条更短、更直接的路径,所需的解剖操作最少,不仅为机器人手术,也为内镜手术提供了足够的操作空间。开发和完善内镜辅助面部提升甲状腺手术的技术是值得的。