Kang Sang-Wook, Chung Woong Youn
Department of Surgery, Yonsei University College of Medicine, C.P.O. Box 8044, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, South Korea.
Gland Surg. 2015 Oct;4(5):388-96. doi: 10.3978/j.issn.2227-684X.2015.06.01.
In head and neck area, neck dissection (ND) is one of the most complex and precision-needed procedure. The long cervical scar and post-operative neck discomfort have been also inevitable brands after this procedure. Heretofore, few dare to try endoscopic surgical technique to the ND mainly due to its complexity and jeopardy of complication. Although, there have been several reports about the endoscopic approaches for functional ND or ND, they had so many technical and instrumental limitations. The dexterities of the surgical robotics have advanced the techniques of endoscopic surgery, and have facilitated the most precise and delicate endoscopic surgical procedure in head and neck area. The technical feasibility and early surgical outcomes of robotic ND using the transaxillary approach for the management of metastatic thyroid cancer have already been reported as satisfactory. Robotic ND can allow complete compartment-oriented lymph node (LN) dissection without any fatal complications, or compromising oncologic principles. We previously described a novel method of robotic thyroidectomy with ND using a gasless transaxillary approach for metastatic thyroid cancer, and here, we firstly introduce a less invasive robotic procedure which has been modified from the original one, which we refer to as the transaxillary single-incision robotic ND.
在头颈部区域，颈部清扫术（ND）是最复杂且需要精确操作的手术之一。术后颈部长期的疤痕和不适也是该手术后不可避免的印记。迄今为止，很少有人敢尝试将内镜手术技术应用于颈部清扫术，主要是因为其复杂性和并发症的危险性。尽管已经有几篇关于功能性颈部清扫术或颈部清扫术的内镜手术方法的报道，但它们存在许多技术和器械上的局限性。手术机器人的灵活性推动了内镜手术技术的发展，并使得在头颈部区域能够进行最精确、最精细的内镜手术。经腋窝入路机器人颈部清扫术治疗转移性甲状腺癌的技术可行性和早期手术效果已被报道为令人满意。机器人颈部清扫术能够在不出现任何致命并发症的情况下，完整地进行基于分区的淋巴结清扫，同时也不会违背肿瘤学原则。我们之前描述了一种用于转移性甲状腺癌的经腋窝无气入路机器人甲状腺切除术联合颈部清扫术的新方法，在此，我们首先介绍一种在原始方法基础上改进的微创机器人手术，即经腋窝单切口机器人颈部清扫术。
