内镜甲状腺手术免气腋窝入路“三牵引”悬吊法。
"Three-propulsion" suspension method for endoscopic thyroid surgery gasless axillary approach.
机构信息
1. Medical College of Qingdao University, Qingdao 266000, Shandong Province, China.
2. Department of Head and Neck Surgery, Center of Otolaryngology, Head and Neck Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital of Hangzhou Medical College, Hangzhou 310014, China.
出版信息
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2021 Dec 25;50(6):694-700. doi: 10.3724/zdxbyxb-2021-0337.
Gasless endoscopic thyroidectomy through unilateral axillary approach has advantages of clear vision, simple manipulation, short learning curve, hidden surgical incision, no postoperative neck scar, and less swallowing discomfort. During the procedure the separation path goes through thoracic muscle surface, sternocleidomastoid gap and jugular vein, which may meet various variations of neck muscles, blood vessels and nerves. With the "three-propulsion" suspension cavity construction method the procedure advances the dissection from the axillary incision to clavicle, from the clavicle to sternocleidomastoid gap and from the sternocleidomastoid gap to thyroid. Combined with intraoperative hanging upward hook it can establish a good cavity for the subsequent surgical operation. This article introduces the main steps, key points and attentions of the "three-propulsion"suspension cavity construction method in gasless endoscopic thyroidectomy through unilateral axillary approach.
经腋下单侧入路无气腔内镜甲状腺切除术具有视野清晰、操作简单、学习曲线短、手术切口隐蔽、术后颈部无瘢痕、吞咽不适少等优点。手术过程中，分离路径经过胸肌表面、胸锁乳突肌间隙和颈静脉，可能会遇到各种颈部肌肉、血管和神经的变异。采用“三推进”悬吊腔构建方法，从腋窝切口推进至锁骨、从锁骨推进至胸锁乳突肌间隙、从胸锁乳突肌间隙推进至甲状腺。结合术中向上悬吊钩，可为后续手术操作建立良好的腔隙。本文介绍了经腋下单侧入路无气腔内镜甲状腺切除术中“三推进”悬吊腔构建方法的主要步骤、要点和注意事项。
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