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单孔机器人乳晕入路甲状腺切除术的首次经验

First Experience of Single-Port Robotic Areolar Approach Thyroidectomy.

作者信息

Choi Yun Suk, Choi Ji Hyun, Jeon Mi Sook, Yu Min Jung, Lee Hye Mi, Shin Ae Young, Yi Jin Wook

机构信息

Department of Surgery, Inha University Hospital, Inha University College of Medicine, Incheon, Korea.

Robot Surgery Center, Inha University Hospital, Inha University College of Medicine, Incheon, Korea.

出版信息

Clin Exp Otorhinolaryngol. 2023 Aug;16(3):275-281. doi: 10.21053/ceo.2023.00682. Epub 2023 Jul 5.

Abstract

OBJECTIVES

Numerous minimally invasive thyroidectomy techniques have been developed and are actively utilized in hospitals around the globe. Herein, we describe a recently developed minimally invasive thyroidectomy technique that employs the da Vinci SP, and we present the preliminary clinical outcomes of single-port robotic areolar thyroidectomy (SPRA).

METHODS

A 3-cm semi-circular incision on the right areola and a small 8-mm incision on the left areola were created. Using hydro-dissection and an advanced bipolar device, a subcutaneous skin flap was created, extending from the areola to the thyroid cartilage. The da Vinci SP was then inserted through the incision in the right areola. Between December 2022 and March 2023, 21 SPRA procedures were conducted. Patients' medical records and surgical videos were subsequently reviewed.

RESULTS

Lobectomy was performed in 17 patients, isthmectomy in 2 patients, and total thyroidectomy in 2 patients. The mean flap time was 14.9±4.2 minutes and the console time was 62.4±17.1 minutes. The mean tumor size was 0.89± 0.65 cm and the number of retrieved lymph nodes was 3.94±3.98 (range, 0-12). There were no observed instances of vocal cord palsy or hypoparathyroidism.

CONCLUSION

We successfully developed and performed the novel SPRA for the first time worldwide. Unlike other robotic surgery.

METHODS

SPRA is less invasive and leaves no visible scars. This technique employs a sophisticated single-port robotic device. However, to assess the efficacy of this method, we need to analyze more cases and conduct comparative studies in the near future.

摘要

目的

众多微创甲状腺切除术技术已被开发出来,并在全球各地的医院中得到积极应用。在此,我们描述一种最近开发的采用达芬奇SP的微创甲状腺切除术技术,并展示单孔机器人乳晕入路甲状腺切除术(SPRA)的初步临床结果。

方法

在右侧乳晕处做一个3厘米的半圆形切口,在左侧乳晕处做一个8毫米的小切口。使用水分离法和先进的双极设备,制作一个从乳晕延伸至甲状软骨的皮下皮瓣。然后将达芬奇SP通过右侧乳晕的切口插入。在2022年12月至2023年3月期间,进行了21例SPRA手术。随后对患者的病历和手术视频进行了回顾。

结果

17例患者行叶切除术,2例患者行峡部切除术,2例患者行全甲状腺切除术。平均皮瓣制作时间为14.9±4.2分钟,控制台操作时间为62.4±17.1分钟。平均肿瘤大小为0.89±0.65厘米,回收淋巴结数量为3.94±3.98个(范围为0 - 12个)。未观察到声带麻痹或甲状旁腺功能减退的情况。

结论

我们首次在全球成功开发并实施了新型SPRA。与其他机器人手术不同,SPRA侵入性较小且不留可见疤痕。该技术采用了先进的单孔机器人设备。然而,为评估该方法的疗效,我们需要在不久的将来分析更多病例并进行对比研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7bb/10471905/6b9788a76a9d/ceo-2023-00682f1.jpg

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