[Minimally invasive endocrine surgery: aspects of diagnostic imaging].
Since 1997 minimally invasive surgical techniques are used for the treatment of diseases of the adrenals, thyroid, parathyroid and the endocrine pancreas. In contrast to open surgical procedures special radiological examinations are the basis for minimally invasive techniques after biochemical testing. The basis of excellent results are a careful evaluation and preparation of the patient in a centre with experience in the open techniques and a frequency of at least 20 endoscopic adrenalectomies a year. Adrenal tumours can be removed endoscopically through a transperitoneal or an extraperitoneal route. The endoscopic exploration of the parathyroids in patients with biochemically proven primary hyperparathyroidism was modified to video-assisted exploration because of the long operating times. An alternative to the video-assisted procedure is the minimally invasive open exploration. With this technique reoperations can be performed and ipsilateral thyroid nodules (found in more than 50% in middle Europe) can be removed. Small solitary thyroid nodules are the indication for an endoscopic or video-assisted exploration of the thyroid. A laparoscopic exploration of the pancreas was performed in 68 patients with neuroendocrine pancreatic tumours. The experience of the surgical team improves the postoperative long term results, thus minimally invasive endocrine surgery should be performed in centres with great experience in the treatment of endocrine tumours and with the possibility of close contact to other specialists interested in this topic.
Niederle
Bruno
B
Sektion Chirurgische Endokrinologie, Klinische Abteilung für Allgemeinchirurgie, Universitätsklinik für Chirurgie, Wien, Osterreich. bruno.niederle@akh-wien.ac.at
Prager
Gerhard
G
Kaczirek
Klaus
K
Scheuba
Christian
C
Passler
Christian
C
Asari
Reza
R
D003952:Diagnostic Imaging; D004701:Endocrine Gland Neoplasms / Q000175:diagnosis / Q000601:surgery*; D004700:Endocrine System Diseases / Q000175:diagnosis / Q000601:surgery*; D004724:Endoscopy; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D012680:Sensitivity and Specificity