Endoscopic parathyroidectomy by a gasless approach

被引:97
作者
Miccoli, P
Bendinelli, C
Conte, M
Pinchera, A
Marcocci, C
机构
[1] Univ Pisa, Dipartimento Chirurg, I-56100 Pisa, Italy
[2] Univ Pisa, Dept Endocrinol, I-56100 Pisa, Italy
来源
JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES-PART A | 1998年 / 8卷 / 04期
关键词
D O I
10.1089/lap.1998.8.189
中图分类号
R61 [外科手术学];
学科分类号
摘要
Endoscopic approach for the treatment of primary hyperparathyroidism is one of the new fields of interest for minimally invasive surgery. The removal of the parathyroid gland can be achieved either by a gas or gasless technique. Massive carbon dioxide (CO2) diffusion and absorption has been reported to occur during the gas procedure. Endoscopic techniques that do not rely on CO2 insufflation have still to be set. We have developed a new procedure that was offered to 20 selected patients with a localized parathyroid adenoma, A 3-minute CO2 insufflation (12 mm Hg) through a conventional trocar inserted under the strap muscles is used just to anatomically dissect the virtual thyrotracheal groove. Actually, the working space is maintained by means of skin retractors so as to allow needlescopic instruments to perform a parathyroid adenomectomy with the gasless procedure. In all cases the parathyroid adenoma was removed through a 1.5-cm skin incision, Quick parathyroid hormone assays always confirmed the removal of all pathologic glands and permitted unilateral cervical exploration. Mean operative time was 71.7 +/- 35.5 minutes. No complication was registered. At follow-up, all patients were normocalcemic, This new endoscopic approach to the neck seems to be safe, effective, and cosmetically satisfactory.
引用
收藏
页码:189 / 194
页数:6
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