[Endoscopic thyroidectomy via median approach with gas insufflation: analysis of the first 100 cases].
OBJECTIVE
To report the initial experience with videoscopic thyroidectomy using a cervical approach with median placement of the optical trocar and gas insufflation.


METHODS
Retrospective study of the first 100 consecutive patients.


RESULTS
Seven isthmectomies, 86 lobectomies, and 7 total thyroidectomies were performed. Parathyroidectomy for hyperparathyroidism was also performed in 3 patients. Mean operative time was 77 minutes. No post-operative subcutaneous emphysema was noted. Conversion to open surgery occurred in 10% of cases but the conversion rate decreased to 2.6% when the harmonic scalpel became available. Post-operative complications included one transient recurrent laryngeal nerve palsy. There were no hematomas and no hypocalcemia. The mean post-operative pain scale was 2.7 (on a visual scale of 1-10). Mean hospital stay was 1.5 days. The cosmetic result was considered excellent.


CONCLUSIONS
Endoscopic total thyroidectomy aided by gas insufflation is technically feasible. The harmonic scalpel aids greatly in dissection and hemostasis. It is a valid option in the surgical management of thyroid disease but careful pre-operative selection of patients is mandatory.
Cougard
P
P
Service de Chirurgie générale et endocrinienne, CHU de Dijon, Hôpital général - Dijon. patrick.cougard@chu-dijon
Osmak-Tizon
L
L
Balestra
L
L
Dancea
R
R
Goudet
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy; D005240:Feasibility Studies; D005260:Female; D006042:Goiter / Q000000981:diagnostic imaging / Q000601:surgery*; D006044:Goiter, Nodular / Q000601:surgery; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000175:diagnosis; D018579:Patient Selection; D011183:Postoperative Complications; D012189:Retrospective Studies; D013965:Thyroidectomy / Q000295:instrumentation / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D014465:Ultrasonics; D014463:Ultrasonography