Mohamed Salah, MD. Faculty Of Medicine Benisuef University
Introduction: Videoscopic neck surgery is developing despite the fact that only potential spaces exist in the neck. Gagner first described the endoscopic subtotal parathyroidectomy with constant CO2 gas insufflations for hyperparathyroidism in 1996. The cervical approach utilizes small incisions in the neck thus making it cosmetically unacceptable and cannot be used for lesions greater than 4 cm. The axillary approach makes it difficult to visualize the opposite lobe. The anterior chest wall approach utilizes port access at various positions on the anterior chest wall depending on the surgeon This technique also allows bilateral neck exploration. Hence we have been able to perform total thyroidectomies with central compartment clearance for papillary carcinoma and near-total thyroidectomies for large multinodular goiters,
MATERIALS AND METHODS:
Three incisions
subplatysmal plane
Pneumoinsufflation with carbon dioxide (CO2)
Ports
Creating a subplatysmal palne
Dissection begins at the inferior pole
Posterior dissection
Clipping superior thyroid vessels
Specimen freed up
Thyroid lobectomy was performed in the twenty cases.
The average blood loss was 40 ml
Mean operative time was 85 min
There were no complications and no cases were converted to open.
There were no cases of recurrent laryngeal nerve injury or postoperative tetany.
No subcutaneous emphysema, ecchymosis or hypercarbia was observed in any patient
All patients were discharged on the second postoperative day except the first on the fifth day.
In conclusion this approach seems to be safe in case of unilateral lobectomy but early to say it is superior to conventional thyroidectomy especially in total thyroidectomy.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87709
Program Number: P673
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster