Key points of surgical anatomy for endoscopic thyroidectomy via a gasless unilateral axillary approach.

IF 2.1 3区医学 Q2 SURGERY Langenbeck's Archives of Surgery Pub Date : 2024-10-01 DOI:10.1007/s00423-024-03473-y

Kexin Meng, Ying Xin, Zhuo Tan, Jiajie Xu, Xiaoliang Chen, Jincong Gu, Parikh Nikhilkumar Jagadishbhai, Chuanming Zheng

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Abstract

Purpose: Endoscopic thyroidectomy utilizing the Gasless Unilateral Axillary Approach (GUA) offers distinct advantages including clear visibility, simple manipulation, safe oncological outcomes. This technique eliminates postoperative neck scarring, ensures concealed surgical incisions, and minimizes postoperative swallowing discomfort.

Methods: We retrospectively reviewed 150 surgical videos to document key anatomical features and their variations during this procedure.

Results: The GUA endoscopic thyroidectomy, which approaches from the contralateral side, presents significant difficulties in identifying anatomical structures, especially anatomical abnormalities in the contralateral neck, while constructing feasible operative fields. This article offers an in-depth discussion of the anatomical challenges, pitfalls, and viable strategies associated with this surgery, particularly for less experienced surgeons.

Conclusions: Given the intricate interplay of muscular, vascular, and neural anatomical structures, novices in surgery must be well-acquainted with the underlying anatomy to minimize potential complications.

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通过无气单侧腋窝入路进行内窥镜甲状腺切除术的手术解剖要点。

目的：采用无气单侧腋窝入路（GUA）的内窥镜甲状腺切除术具有清晰可见、操作简单、肿瘤治疗安全等显著优势。该技术可消除术后颈部瘢痕，确保手术切口隐蔽，并将术后吞咽不适降至最低：我们回顾性地查看了 150 个手术视频，记录了该手术过程中的主要解剖特征及其变化：GUA内镜甲状腺切除术从对侧入路，在识别解剖结构，尤其是对侧颈部的解剖异常，同时构建可行的手术野方面存在很大困难。本文深入探讨了与该手术相关的解剖难题、陷阱和可行策略，尤其是对经验不足的外科医生而言：鉴于肌肉、血管和神经解剖结构之间错综复杂的相互作用，手术新手必须熟知基本的解剖结构，以最大限度地减少潜在的并发症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Langenbeck's Archives of Surgery 医学-外科

CiteScore

3.30

自引率

8.70%

发文量

342

审稿时长

4-8 weeks

期刊介绍： Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.