Transorale partielle Parathyreoidektomie

Karakas, Elias; Steinfeldt, T.; Gockel, Andreas; Sesterhenn, Andreas M.; Bartsch, Detlef K.

doi:10.1007/s00104-010-1922-6

Cited by 10 publications

(8 citation statements)

References 18 publications

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“…For example, Fowkes et al [7] reported the feasibility of evaluating and diagnosing pleural disease using a single cervical incision in 15 patients. Karakas et al [8] reported the safety of the transoral method for partial parathyroidectomy in a 37-year-old woman with primary hyperparathyroidism. More recently, Wilhelm et al [9] reported the safety and feasibility of the transoral approach for the performance of thymectomy in a live pig.…”

Section: Discussionmentioning

confidence: 98%

Single-dose antimicrobial prophylaxis in transoral surgical lung biopsy: a preliminary experience

Liu

Yen-Chu

et al. 2011

Surg Endosc

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Section: Discussionmentioning

confidence: 98%

Single-dose antimicrobial prophylaxis in transoral surgical lung biopsy: a preliminary experience

Liu

Yen-Chu

et al. 2011

Surg Endosc

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“…In contrast to others [5], we were able to gain significant results concerning microbiologic examinations of the operation field or possible injuries of the recurrent laryngeal nerves at risk. We also performed additional hemithyroidectomies and parathyroidectomies in human cadavers [6].Based on the results of these experiments, we were able to establish the new transoral approach in the clinical setting and recently performed a transoral partial parathyroidectomy on two female patients with primary hyperparathyroidism [7]. In conclusion, it is correct to state that our study was the first to demonstrate the feasibility of a transoral resection of parathyroid glands and thyroid lobes using an entirely transoral access to the thyroid region.…”

mentioning

confidence: 73%

“…Based on the results of these experiments, we were able to establish the new transoral approach in the clinical setting and recently performed a transoral partial parathyroidectomy on two female patients with primary hyperparathyroidism [7]. In conclusion, it is correct to state that our study was the first to demonstrate the feasibility of a transoral resection of parathyroid glands and thyroid lobes using an entirely transoral access to the thyroid region.…”

mentioning

confidence: 77%

Transoral parathyroid surgery—feasible!

et al. 2010

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We read with interest the letter of Benhidjeb and colleagues [1] in response to our article [2] and are grateful for the opportunity to reply. Benhidjeb and colleagues criticize our claim to the first description of an entirely transoral access for hemithyroidectomy and parathyroidectomy without an accessorial incision of the skin in pigs and human cadavers as wrong. We respectfully disagree.Our project, Transoral Thyroid and Parathyroid Surgery, initially called NOTES-PTX and focused especially on parathyroidectomy, was initiated in the Department of Visceral, Thoracic, and Vascular Surgery at the University Hospital Marburg, July 2007. At that time, even the hybrid technique of Witzel et al. [3] had not been published. Thus, unaware and independently of the experiences of other groups, we developed an entirely transoral access to the thyroid and parathyroid region using one rigid cervicoscope without the need for gas insufflation or additional skin incisions. The technique was modified and optimized in human cadavers and living juvenile pigs (25-35 kg), including the development of new instruments and the introduction of intraoperative neuromonitoring.We presented the first promising results for transoral thyroid and parathyroid surgery at the annual meeting of the Chirurgische Arbeitsgemeinschaft Endokrinologie (CAEK) in Rostock, Germany. These results were published as an abstract in Langenbeck's Archive of Surgery in 2008 [4]. We admit that in 2009, Benhidjeb and colleagues first described an experimental totally transoral videoassisted thyroidectomy (TOVAT) in a short note [5]. However, their study investigating five human cadavers focused exclusively on thyroidectomy. They neither performed nor mentioned parathyroidectomy in their reports. Their preferred subplatysmal access route, including gas insufflation and the use of three trocars instead of one cervicoscope, differs substantially from our technique. Moreover, the access route and technique favored by Benhidjeb and colleagues [1] make it difficult to locate the parathyroid glands and the recurrent laryngeal nerve before dissection of the isthmus as well as the upper and lower poles of the thyroid lobe.We focused on improvement of our new technique by carrying out surviving studies with pigs, including a 14-day follow-up assessment. In contrast to others [5], we were able to gain significant results concerning microbiologic examinations of the operation field or possible injuries of the recurrent laryngeal nerves at risk. We also performed additional hemithyroidectomies and parathyroidectomies in human cadavers [6].Based on the results of these experiments, we were able to establish the new transoral approach in the clinical setting and recently performed a transoral partial parathyroidectomy on two female patients with primary hyperparathyroidism [7]. In conclusion, it is correct to state that our study was the first to demonstrate the feasibility of a transoral resection of parathyroid glands and thyroid lobes using an entirely transoral access to t...

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“…2). A small series of transoral parathyroidectomies for primary hyperparathyroidism has been reported [56,58], while recent investigations have utilized surgical robotics for thyroid resection and neck dissection in human cadavers [59]. …”

Section: Transoral Proceduresmentioning

confidence: 99%

“…After implementation and improvement of this transoral access to the thyroid region in an animal model and in human cadavers [55,56,57,58], the NOTES concept has been applied to the surgery of the thyroid and parathyroid glands (fig. 2).…”

Section: Transoral Proceduresmentioning

confidence: 99%

NOTES: Current Status and Recent Developments

Antoniou

Bartsch

2012

Visc Med

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Background: The beneficial clinical results of laparoscopic surgery have prompted modern investigations to further minimize surgical trauma and to optimize cosmetic results. Natural orifice transluminal endoscopic surgery (NOTES®) refers to the surgical concept of entering the surgical field through a body lumen for diagnostic and therapeutic purposes without producing visible scars. Method: A review of the current literature was undertaken by means of the electronic databases Excerpta Medica and EMBASE. Results: Although the level of clinical evidence is low, the concept of NOTES has found clinical application in a variety of abdominal procedures, such as cholecystectomy, appendectomy, and sigmoidectomy. The vagina represents the most frequent access route for NOTES while the stomach, the rectum, and the transoral approach are further options. Several clinical studies have demonstrated the feasibility of a wide variety of NOTES procedures; however, there are currently no hard data supporting the superiority of this approach over conventional laparoscopic techniques. Furthermore, inherent limitations of the NOTES concept, such as the loss of triangulation, difficult tissue manipulation, and the potential contamination of the surgical field, warrant technological advances in medical endoscopy, instrumentation, and endoscopic tissue closure. Conclusions: In its current status, NOTES has to be considered as a stage towards minimization of surgical access trauma rather than as an established surgical concept.

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Transorale partielle Parathyreoidektomie

Cited by 10 publications

References 18 publications

Single-dose antimicrobial prophylaxis in transoral surgical lung biopsy: a preliminary experience

Single-dose antimicrobial prophylaxis in transoral surgical lung biopsy: a preliminary experience

Transoral parathyroid surgery—feasible!

NOTES: Current Status and Recent Developments

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