Transoral periosteal thyroidectomy: cadaver to human

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• 作者：Hye Yoon Lee ; Ji Young You ; Sang Uk Woo ; Gil Soo Son ; Jae Bok Lee…
• 关键词：Thyroidectomy ; Transoral ; Periosteal ; Minimally invasive
• 刊名：Surgical Endoscopy
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：29
• 期：4
• 页码：898-904
• 全文大小：3,546 KB
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgery
  Gynecology
  Gastroenterology
  Hepatology
  Proctology
  Abdominal Surgery
  
• 出版者：Springer New York
• ISSN：1432-2218

文摘

Background Although endoscopic thyroid surgery is gaining wide acceptance, existing endoscopic methods for thyroidectomy are blamed for the increased frequency of flap dissections and longer surgical times. More recently, transoral endoscopic thyroidectomy has overcome the limitations of previous approaches. Herein, we present our initial experience with transoral periosteal thyroidectomy (TOPOT) in cadaver and porcine models. Using these models, the surgical view was improved and had greater freedom of motion; the technique was then performed in human subjects using robotic TOPOT, which has not previously been reported. Method TOPOTs were performed in seven fresh human cadavers and ten live pigs. Total thyroidectomies were performed in all cadavers and pigs. After the cadaver and animal trials, four human patients underwent robotic TOPOT performed using the da Vinci? surgical system at Korea University Anam Hospital. Recurrent laryngeal nerve function, intra- and postoperative complications, and postoperative outcomes were assessed in all patients. Result One left lobectomy for follicular adenoma, two right lobectomies for nodular hyperplasia, and one left lobectomy with a central neck dissection for papillary thyroid microcarcinoma were performed in the human subjects using a robotic transoral periosteal approach. In three cases, paresthesia occurred in the mental nerve, but this improved within 4?weeks in all cases. No local infections occurred at the incision site or anterior neck, and no recurrent laryngeal nerve cord palsies occurred postoperatively. Conclusion TOPOT may be an effective and safe approach for robotic thyroid surgery.