Yoshiyuki Usui, MD, PhD, Ichiro Akiyama, MD, PhD, Hironori Kunisue, MD, PhD, Hideaki Mori, MD, PhD, Tetsuya Ota, MD, PhD. Okayama Medical Center
Background and Methods: We have performed approximately 200 cases of gasless endoscopic thyroid surgery since 1999 for 17 years. This surgery was performed through a small subclavian incision and using a wire traction and inserting an endoscope. We have modified and improved our surgical techniques by inventing various surgical instruments. Here we introduce four newly invented surgical instruments, chronologically.
Results: We made U-retractor (2000), U-trocar (2005), U-Kelly forceps (2008), and U-suction tube retractor (2013). All surgical instruments were modified from conventional surgical instruments. The U-retractor was a piercing retractor, each end of which had a sharp tip and a retractor. This retractor was inserted from the 3-cm working port outside the body and retracted the muscles effectively. The U-trocar was reversely set from inside to outside to make the working space wider. The U-Kelly forceps which had a special ratchet were made to dissect loose connective tissue around the thyroid gland avoiding injury of the recurrent laryngeal nerve. The U-suction tube retractor facilitated a wider working port and eliminated the mist created by the ultrasonically activated scalpel effectively. Recent data showed no difference of operative time, hoarseness, blood loss and hospital stay between conventional thyroid lobectomy and gasless endoscopic lobectomy.
Conclusion: Gasless endoscopic thyroid surgery has been improved in the last 17 years. This procedure made the excision of not only benign thyroid tumors but also small thyroid carcinomas. This operation is still cost effective, because almost all surgical instruments are reusable and is a satisfactory experience to both the patients and surgeons.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 84839
Program Number: P825
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster