• Korean Journal of Head & Neck Oncology
• /
• v.30 no.1
• /
• pp.10-14
• /
• 2014

목 적 CO2 가스 삽입 없이 내시경 보조 갑상선 절제술, 특히 액와 절개를 이용하는 경우의 대부분은 기구 사용을 용이하게 하기 위하여 흉부 또는 유륜에 절개를 넣어 시행하는 것이 대부분이다. 본 연구는 후이개 절개를 통하여 추가적 절개 없이 내시경을 이용한 갑상선 절제술 및 중심 임파선 절제술이 가능한지의 여부를 사체연구를 통하여 확인해 보고자 한다. 방 법 사체 이용 해부 및 수술 후이개 내시경 보조 갑상선 절제술이 가능한지의 확인은 수술 시야 및 접근성, 수술 완성도, 그리고 주요 구조물의 보존 여부인 3가지 항목으로 평가하였다. 결 과 수술 시야는 기구를 다루고 수술을 하기에 충분하였으며, 추가 절개 없이 수술을 완성할 수 있었다. 절제된 갑상선 조직의 피막은 손상되지 않았으며, 잔존 갑상선 조직이 없음을 수술 부위를 통하여 확인하여, 수술의 완성도 여부를 평가할 수 있었다. 모든 사체에서 되돌이 후두신경 및 상 또는 하부갑상선의 보존을 확인하였으며, 주변 구조물들의 손상이 없음을 확인하였다. 결 론 로봇이 아닌 후이개 절개를 이용한 내시경 보조 갑상선 절제술은 시행 가능한 접근법 및 수술방법이라 사료된다.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.16 no.10
• /
• pp.6985-6991
• /
• 2015

Purpose: Various new techniques in thyroid surgery have been developed to improve visualization and reduce risk of complications. New approaches for robotic endoscopic thyroidectomy help to prevent neck scarring and improve surgical ergonomics. The purpose of this study was to compare the efficacy and adventages of an axillo-breast approach (AB group) and an only-axillary approach (OA group) in robotic endoscopic thyroidectomy. Methods: Between November 2008 and July 2014, axillo-breast approach was performed in 128 patients and only-axillary approach was performed in 128 patients for robotic endoscopic thyroidectomy. We compared tumor characteristics, surgical outcomes, and postoperative complications between the two approaches. The homogeneity between two groups of general characteristics was analyzed by independent t-test, fisher's exact test, Chi-square test. Results: There were no differences in terms of tumor characteristics, extent of thyroidectomy, retrieved nodes, and postoperative complications between the two approaches. The patients in OA group can avoid breast scar. Conclusion: Our techniques of AB and OA approaches for robotic endoscopic thyroidectomy are safe, feasible, and cosmetically excellent procedures. Also the OA approach for robotic endoscopic thyroidectomy is an attractive surgical option for patients with thyroid tumor who want an avoid breast scar.

• Korean Journal of Head & Neck Oncology
• /
• v.23 no.1
• /
• pp.46-49
• /
• 2007

Soft tissue implantation of thyroid tissue is a very rare event. Needle tract implantation of thyroid carcinoma after fine-needle aspiration (FNA) biopsy has been occasionally reported, but implantation of benign thyroid tumor tissue is extremely rare. Rupture of thyroid tissues during surgery or trauma may cause the thyroid tissue to be implanted and result in multiple palpable nodules in soft tissue of the neck. Several reports have shown the possibility of implantation of normal or hyperplastic thyroid tissues in soft tissue. We herein report a case of implantation of adenomatous hyperplastic tissue in the neck along the trochar and previous operation site after endoscopic thyroid surgery, which was successfully treated by complete excision.

• International journal of thyroidology
• /
• v.11 no.2
• /
• pp.109-116
• /
• 2018

It is very important to identify recurrent laryngeal nerve (RLN) and prevent RLN injury during thyroid surgery. The intraoperative neuromonitoring (IONM) for the prevention of RLN injury is a useful method because it can identify the location and status of RLN and predict postoperative vocal cord function easily. The IONM consists of a stimulating side that applies electrical stimulation to the nerve and a recording side that measures the surface electromyography (EMG) of the vocal cord muscle through electrode endotracheal tube. The nerve stimulator and surgical dissector are separate instruments. So, during IONM for the prevention of the RLN injury in conventional, endoscopic, or robotic thyroid surgery, repeated exchanging between surgical instruments and the nerve stimulator is inconvenient and time consuming. On the recording side, the accuracy of the electrode endotracheal tube which measures the EMG of the vocalis muscle can be affected by contact with between electrode and vocal fold and position change of patient. We would like to introduce recent several researches to overcome the current limitations of IONM.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
• /
• v.61 no.12
• /
• pp.697-701
• /
• 2018

Background and Objectives The aim of this study was to evaluate surgical completeness in endoscopic total thyroidectomy with central neck dissection via unilateral axillo-breast approach (UABA) compared with bilateral axillo-breast (BABA) and open approach (OA) by means of the radioactive iodine uptake (RAIU) ratio and thyroglobulin (Tg) of remnant thyroid. Subjects and Method From July 2010 to March 2013, 82 patients who had underwent total thyroidectomy with central neck dissection and postoperative radioactive iodine (RAI) ablation for papillary thyroid carcinoma were enrolled. Of these patients, 27 patients underwent UABA, 24 patients BABA, and 31 patients OA. Clinicopathologic data, surgical outcome, stimulated Tg and RAIU ratio on the first postoperative RAI ablation scan were compared among 3 groups. Results Patients in the endoscopic surgery groups (UABA, BABA) were younger than those in the OA groups. Invasiveness such as operation time, postoperative pain, and drain amount in UABA was less than that in BABA and severer than that in OA. Other variables regarding clinicopathologic and surgical data were not significantly different. Stimulated Tg and RAIU ratio did not show significant differences among 3 groups (p=0.659 and p=0.664). Conclusion The completeness of UABA was comparable with that of BABA and OA. The UABA may be a safe option for patients who need endoscopic thyroidectomy for papillary thyroid carcinoma.