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Endoscopic thyroidectomy: Our technique.

Puntambekar SP, Palep RJ, Patil AM, Rayate NV, Joshi SN, Agarwal GA, Joshi M - J Minim Access Surg (2007)

Bottom Line: All thyroidectomies were completed successfully.It is a safe and effective technique in the hands of an appropriately trained surgeon.The patients get a cosmetic benefit without any morbidity.

View Article: PubMed Central - PubMed

Affiliation: Galaxy Laparoscopy Institute, 25-A, Karve Road, Near Garware College, Pune - 411 004, India.

ABSTRACT

Unlabelled: Minimally invasive surgery is widely employed for the treatment of thyroid diseases. Several minimal access approaches to the thyroid gland have been described. The commonly performed surgeries have been endoscopic lobectomies. We have performed endoscopic total thyroidectomy by the anterior chest wall approach. In this study, we have described our technique and evaluated the feasibility and efficacy of this procedure.

Materials and methods: From June 2005 to August 2006, 15 cases of endoscopic thyroidectomy were done at our institute. Five patients were male and 10 were female. Mean age was 45 years. (Range 23 to 71 years). Four patients had multinodular goiter and underwent near-total thyroidectomy; four patients had follicular adenoma and underwent hemithyroidectomy. Out of the seven patients of papillary carcinoma, four were low-risk and so a hemithyroidectomy was performed while three patients in the high risk group underwent total thyroidectomy. A detailed description of the surgical technique is provided.

Results: The mean nodule size was 48 mm (range 20-80 mm) and the mean operating time was 85 min (range 60-120 min). In all cases, the recurrent laryngeal nerve was identified and preserved intact, the superior and inferior parathyroids were also identified in all patients. No patients required conversion to an open cervicotomy. All patients were discharged the day after surgery. All thyroidectomies were completed successfully. No recurrent laryngeal nerve palsies or postoperative tetany occurred. The postoperative course was significantly less painful and all patients were satisfied with the cosmetic results.

Conclusions: It is possible to remove large nodules and perform as well as total thyroidectomies using our endoscopic approach. It is a safe and effective technique in the hands of an appropriately trained surgeon. The patients get a cosmetic benefit without any morbidity.

No MeSH data available.


Related in: MedlinePlus

Dissection begins at the inferior pole
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Figure 0003: Dissection begins at the inferior pole

Mentions: The dissection was begun at the lower pole of the thyroid gland [Figure 3]. The inferior thyroid pedicle was identified. The recurrent laryngeal nerve was also identified and protected. Inferior thyroid veins were first coagulated with the Harmonic scalpel. Inferior thyroid artery was clipped or coagulated with Harmonic scalpel. In doing so, care was taken to avoid injuring the recurrent laryngeal nerve which is usually located between the trachea and the carotid artery [Figure 4].


Endoscopic thyroidectomy: Our technique.

Puntambekar SP, Palep RJ, Patil AM, Rayate NV, Joshi SN, Agarwal GA, Joshi M - J Minim Access Surg (2007)

Dissection begins at the inferior pole
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2749190&req=5

Figure 0003: Dissection begins at the inferior pole
Mentions: The dissection was begun at the lower pole of the thyroid gland [Figure 3]. The inferior thyroid pedicle was identified. The recurrent laryngeal nerve was also identified and protected. Inferior thyroid veins were first coagulated with the Harmonic scalpel. Inferior thyroid artery was clipped or coagulated with Harmonic scalpel. In doing so, care was taken to avoid injuring the recurrent laryngeal nerve which is usually located between the trachea and the carotid artery [Figure 4].

Bottom Line: All thyroidectomies were completed successfully.It is a safe and effective technique in the hands of an appropriately trained surgeon.The patients get a cosmetic benefit without any morbidity.

View Article: PubMed Central - PubMed

Affiliation: Galaxy Laparoscopy Institute, 25-A, Karve Road, Near Garware College, Pune - 411 004, India.

ABSTRACT

Unlabelled: Minimally invasive surgery is widely employed for the treatment of thyroid diseases. Several minimal access approaches to the thyroid gland have been described. The commonly performed surgeries have been endoscopic lobectomies. We have performed endoscopic total thyroidectomy by the anterior chest wall approach. In this study, we have described our technique and evaluated the feasibility and efficacy of this procedure.

Materials and methods: From June 2005 to August 2006, 15 cases of endoscopic thyroidectomy were done at our institute. Five patients were male and 10 were female. Mean age was 45 years. (Range 23 to 71 years). Four patients had multinodular goiter and underwent near-total thyroidectomy; four patients had follicular adenoma and underwent hemithyroidectomy. Out of the seven patients of papillary carcinoma, four were low-risk and so a hemithyroidectomy was performed while three patients in the high risk group underwent total thyroidectomy. A detailed description of the surgical technique is provided.

Results: The mean nodule size was 48 mm (range 20-80 mm) and the mean operating time was 85 min (range 60-120 min). In all cases, the recurrent laryngeal nerve was identified and preserved intact, the superior and inferior parathyroids were also identified in all patients. No patients required conversion to an open cervicotomy. All patients were discharged the day after surgery. All thyroidectomies were completed successfully. No recurrent laryngeal nerve palsies or postoperative tetany occurred. The postoperative course was significantly less painful and all patients were satisfied with the cosmetic results.

Conclusions: It is possible to remove large nodules and perform as well as total thyroidectomies using our endoscopic approach. It is a safe and effective technique in the hands of an appropriately trained surgeon. The patients get a cosmetic benefit without any morbidity.

No MeSH data available.


Related in: MedlinePlus