Safe incorporation of new technologies in thyroid surgery.
The history of thyroid surgery starts with Billroth, Kocher and Halsted, who developed the technique for thyroidectomy between the years of 1873 and 1910. In general the essential objectives for thyroidectomy are: sparing the parathyroid glands, avoidance of injury to the laryngeal nerves, an accurate hemostasis and an excellent cosmesis. In the last 10 years, major improvements and new technologies have been proposed and applied in thyroid surgery. These include mini-invasive thyroidectomy, new devices for achieving hemostasis and dissection, regional anesthesia, intraoperative neuromonitoring, parathyroid hormone assay technology and genetic screening. This paper reviews the relevant medical literature published on the influence of these new technologies on the quality of thyroid surgery, as well as prevention of postoperative morbidity and mortality. Searches were last updated in April 2008.
Dionigi
Gianlorenzo
G
Center of Endocrine Surgery, Department of Surgical Sciences, University of Insubria, Azienda Ospedaliero-Universitario, Fondazione Macchi, Varese, Italy. gianlorenzo.dionigi@uninsubria.it
Bacuzzi
Alessandro
A
Bertocchi
Valentina
V
Carrafiello
Gianpaolo
G
Boni
Luigi
L
Rovera
Francesca
F
Dionigi
Renzo
R
D000765:Anesthesia, Conduction; D000768:Anesthesia, General; D004564:Electrocoagulation; D015972:Gene Expression Regulation, Neoplastic; D005820:Genetic Testing; D006489:Hemostatic Techniques / Q000295:instrumentation; D006801:Humans; D007011:Hypoparathyroidism / Q000209:etiology / Q000517:prevention & control; D007430:Intraoperative Care; D019060:Minimally Invasive Surgical Procedures; D010281:Parathyroid Hormone / Q000097:blood; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control; D011788:Quality of Life; D013525:Surgical Instruments; D013959:Thyroid Diseases / Q000235:genetics / Q000401:mortality / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000235:genetics / Q000401:mortality / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D016896:Treatment Outcome; D020535:Video-Assisted Surgery; D014826:Vocal Cord Paralysis / Q000209:etiology / Q000517:prevention & control
D010281:Parathyroid Hormone