Modified Transoral Endoscopic Thyroidectomy Technique Using Trapdoor Suspension Sutures

Kim, Su Il; Min, Hye Kyu; Kang, Dae Woong; Choi, Soo Young; Kang, Hee Jin; Lee, Young Chan; Eun, Young Gyu; Ko, Seong‐Gyu

doi:10.21053/ceo.2021.00101

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…In most cases, the surgical wound was clear after 3 months. Third, the transoral approach reduces the operation time [ 47 , 49 , 50 ]. Using an avascular space created via bilateral retraction of the GMs results in minimal bleeding and reduces the number of surgical steps, thereby decreasing the overall time required.…”

Section: Discussionmentioning

confidence: 99%

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Endoscopically-Assisted Scar-Free Midline Neck Mass Excision

Kim

Woo

2021

Clin Exp Otorhinolaryngol

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Traditional open surgery is indicated for the treatment of selected tumor subsites in the head and neck. However, it can cause major cosmetic problems and functional pathologies. The endoscopically-assisted transoral approach is increasingly preferred in some surgical fields due to its superior cosmetic and functional outcomes. Nonetheless, endoscopically-assisted transoral approach is not yet standard in the head and neck due to their anatomical complexity. The transoral surgical approach has been used for head and neck masses since the 1960s, and its application continues to evolve with changing disease conditions and recent innovations in surgical instruments. The potential for wide application of transoral surgery continues to be investigated, with a focus on minimizing occurrence of the complications. This review presents details of the surgical procedure and postoperative clinical outcomes, as well as endoscopically-assisted scar-free techniques for the resection of midline neck masses.

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Section: Discussionmentioning

confidence: 99%

“…However, transoral surgery also has its limitations. The main issue with transoral surgery is wound contamination [49,[51][52][53][54]. Transcervical surgery is considered a "clean" operation, obviating the need for antibiotics.…”

Section: Discussionmentioning

confidence: 99%

Endoscopically-Assisted Scar-Free Midline Neck Mass Excision

Kim

Woo

2021

Clin Exp Otorhinolaryngol

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“…Similar to endoscopic surgery, transoral thyroid surgery generally involves intra-oral incision, establishment of the subplatysmal space, and thyroidectomy [2]. Currently, the primary methods to maintain the operating space encompass insufflation, suspension, pulling, and a combination of insufflationsuspension techniques [3][4][5][6][7]. Insufflation, the most widely used method, offers the advantage of convenient operation without excessive dependence on suspension or traction equipment.…”

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confidence: 99%

A Case of Air Embolism during Transoral Vestibular Endoscopic Thyroidectomy

Xu,

Wang

2023

Asp Biomed Clin Case Rep

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Background: Carbon dioxide (CO2) embolism is a rare but potentially life-threatening complication of endoscopic surgery. While endoscopic thyroidectomy is superior to traditional open thyroidectomy in terms of cosmetic results, it may lead to venous or fatal paradoxical CO2 embolism. CO2 embolism involves the inadvertent injection of carbon dioxide into a large vein, artery, or solid organ. The clinical manifestations of CO2 embolism can vary from asymptomatic to neurological damage, cardiac failure, and even death, depending on the rate and volume of CO2 entry and the patient’s general condition. This case can enhance our understanding of CO2 embolization during endoscopic surgery. Case Presentation: This case report describes an incident in which a gas embolism occurred during endoscopic right lobe and isthmus thyroidectomy, resulting in arrhythmia and dramatic fluctuations in circulation and oxygen levels. The operation was halted, and CO2 injection was stopped. The surgical wound was covered with saline gauze, and the patient inhaled 100% pure oxygen while undergoing aggressive repeated manual pulmonary recruitment maneuvers. Additionally, vasoactive drugs such as m-hydroxyamine and ephedrine were administered to aid in treating the condition. The patient’s position was adjusted using the Durant maneuver (partial left lateral and Trendelenburg position). Following the aforementioned treatments, the patient’s ventricular arrhythmia transitioned back to a normal and regular sinus rhythm, and both circulation and oxygen levels stabilized. Conclusions: Carbon dioxide embolism is an uncommon yet potentially severe complication of laparoscopic procedures. We anticipate that this particular case will enhance our comprehension of carbon dioxide embolism during endoscopic surgery.

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En bloc resection of total thyroid and bilateral central compartment lymph nodes via a gasless transoral approach in papillary thyroid carcinoma

Sheng

Li²,

Fang³

et al. 2023

Front. Endocrinol.

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IntroductionThe current study presents a preliminary exploration of en bloc resection via a gasless transoral approach in papillary thyroid carcinoma.ObjectiveThis study aimed to summarize and explore the efficacy and safety of en bloc resection of total thyroid and bilateral central compartment lymph nodes via a gasless transoral approach in patients with papillary thyroid carcinoma.MethodsThis study was conducted between January 2021 and December 2021. It involved 30 patients with bilateral papillary thyroid carcinoma who had undergone en bloc resection of the total thyroid and bilateral central compartment lymph nodes via a gasless transoral approach using a three-trocar and four-instrument technique at The First Affiliated Hospital of the University of Science and Technology of China. The key steps and difficulties of the operation were summarized, and the clinicopathological characteristics and surgical complications of patients were analyzed.ResultsAll operations were successful without conversion to open surgery. The pathological diagnosis was bilateral papillary thyroid carcinoma. The mean maximum tumor diameter was 0.85 ± 0.51 cm (range 0.3–2.5 cm). There was no case of gross capsular invasion. The mean number of harvested central compartment lymph nodes was 11.36 ± 5.36. Central compartment lymph node metastases were found in 16 patients (53.3%) with a mean of 1.53 ± 2.39. On the other hand, lymphocytic thyroiditis was observed in 12 cases (40%), and microscopic capsular invasion was observed in five cases (16.6%). All patients had normal parathyroid hormone levels after the operation. However, one patient developed hoarseness after the operation due to injury of the recurrent laryngeal nerve branch, but there was no numbness of the mandible and lower lip or infection of the oral incision.ConclusionThe study revealed that the three-trocar and four-instrument technique can be used in the en bloc resection of total thyroid and bilateral central compartment lymph nodes via a gasless transoral approach without disconnecting the thyroid isthmus. As a result, the operation is considered effective and safe. Therefore, this technique may be a better surgical method for patients with bilateral thyroid cancer and cosmetic needs.

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Modified Transoral Endoscopic Thyroidectomy Technique Using Trapdoor Suspension Sutures

Cited by 3 publications

References 8 publications

Endoscopically-Assisted Scar-Free Midline Neck Mass Excision

Endoscopically-Assisted Scar-Free Midline Neck Mass Excision

A Case of Air Embolism during Transoral Vestibular Endoscopic Thyroidectomy

En bloc resection of total thyroid and bilateral central compartment lymph nodes via a gasless transoral approach in papillary thyroid carcinoma

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