Videoscopic thyroidectomy with fine needle-type apparatuses: an approach that does not leave a scar on the neck or anterior chest.
A total videoscopic operation with constant CO(2) gas insufflation is ideal for performing a scarless thyroidectomy because the skin incisions at the surgical ports are made far from the neck in the axillar area. However, there are many difficulties associated with the performance of a videoscopic thyroidectomy when approaching pneumo-subcutaneously from distant ports, because the instruments are inserted tangentially toward the thyroid gland from a distant port and their range of manipulation is limited. The devices and surgical techniques used for a videoscopic thyroidectomy that does not leave a scar on the anterior chest or neck were developed. Fine needle-type cautery and forceps that could access directly to the thyroid gland from the neck were used to support the forceps. A CO(2) reservoir bag connected to the CO(2) insufflation tube contributed to the safer manipulation by the creation of a stable operation space during emitting smoke from coagulation device. A silicon ring stopper was useful to prevent dislodging of the ports. In conclusion, videoscopic neck surgery would be easier using these new devices and techniques and would produce better cosmetic results than video-assisted and conventional neck surgeries.
Asao
Takayuki
T
Department of General Surgical Science, Gunma University, Graduate School of Medicine, Maebashi, Japan. asaot@med.gunma-u.ac.jp
Kuwano
Hiroyuki
H
Yamaguchi
Satoru
S
Uchida
Nobuyuki
N
Yanagita
Yasuhiro
Y
D000328:Adult; D044963:Biopsy, Fine-Needle; D002921:Cicatrix / Q000517:prevention & control*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009333:Neck; D009339:Needles; D013909:Thorax; D016606:Thyroid Nodule / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy / Q000295:instrumentation*; D016896:Treatment Outcome; D020535:Video-Assisted Surgery / Q000295:instrumentation*