Gasless Endoscopic Thyroidectomy via an Anterior Chest Wall Approach Using a Flap-Lifting System

• Published in: Yonsei medical journal pp. 480 - 487
• Main Authors: 조영업, 박일재, 최경호, 김세중, 최선근, 허윤석, 이건영, 안승익, 홍기천, 신석환, 김경래, 우제홍
• Format: Journal Article
• Language: Korean
• Published: 연세대학교의과대학 01.06.2007
• Subjects: 의학일반
• ISSN: 0513-5796; 1976-2437

Purpose: Endoscopic thyroidectomy (ET) requires a proper working space for adequate visualization of anatomical structures and proper instrument manipulation. The purpose of this prospective study was to estimate the feasibility and safety of ET using an anterior chest wall approach without gas insufflation. Materials and Methods: The working space was created under a direct and endoscopic view through a 3-cm incision on the anterior chest wall. A retracting device was then inserted to establish the working space, and subsequent procedures were performed endoscopically. All data were reviewed using a prospective database. Results: We performed 30 ETs in patients with benign thyroid tumors from December 2003 to December 2005. The procedures were completed successfully in 29 patients (mean operative time: 160.6 min; range: 90-345 min). One patient with ET was converted to open thyroidectomy secondary to substernal extension of the tumor. None of the patients developed permanent postoperative hypocalcemia or recurrent laryngeal nerve paralysis. Three patients exhibited some degree of transient recurrent laryngeal nerve palsy. Conclusion: These data suggest that gasless ET using an anterior chest wall approach is safe and feasible in selected patients for treating benign thyroid tumors. This technique may offer good operative working space when performed by surgeons with relatively low-volume ET practices. KCI Citation Count: 34