Left thyroid lobectomy using the new Ligasure Precise®

作者群

摘要

Modern devices have improved surgical results. This video demonstrates the usefulness of the new Ligasure Precise™ during left thyroid lobectomy.

分類

contribution

關鍵字

Left thyroid lobectomy, Ligasure Precise®

媒體類型

期間

07'37''

刊物

2011-04

普通的

最愛

音訊

副標題

數位出版

WeBSurg.com, Apr 2011;11(04).
URL: http://www.websurg.com/doi-vd01en3284.htm

Left thyroid lobectomy using the new Ligasure Precise®

1. Clinical case presentation 00'22''

We present the case of a 50-year-old man presenting with a single nodule of the left thyroid lobe. Thyroid function tests were normal. No thyroiditis was evidenced. Total thyroid volume (as estimated by ultrasound) was 40 mL. Preoperative ultrasound examination revealed the presence of a 5cm isohypoechoic nodule with perinodular vascularization. Fine needle aspiration biopsy showed a benign cytology.

2. Kocher incision 00'54''

A conventional Kocher incision of 5cm is performed.

3. Subcutaneous flaps 00'59''

Subcutaneous flaps are prepared using electrocautery following a totally avascular plane.

4. Midline opening 01'29''

The midline is opened between the strap muscles from the thyroid cartilage until the sternal notch. This operation is performed using the Ligasure Precise™ Plus. This new device allows to dissect, coagulate and cut tissues, which means an important time saving in the overall operative time and allows to perform an entire surgical procedure using a single device.

5. Division of middle thyroid vein 01'57''

Once the midline has been completely opened, access to the left thyroid space is gained. A large nodule can be identified at the left lobe. The middle thyroid vein is isolated and divided.

6. Left lobe mobilization 02'33''

The left thyroid lobe is mobilized from its space with a single gesture following a bloodless plane.

7. Upper pedicle division 02'53''

The upper pedicle is isolated and divided using the new Ligasure Precise™ Plus. No ties are necessary even to seal these large vessels.

8. Identification of left recurrent laryngeal nerve 03'31''

The left recurrent laryngeal nerve is visualized and traced until its entrance into the larynx.

9. First inferior thyroid artery branch division 03'51''

A branch of the inferior thyroid artery is divided by means of the new Ligasure Precise™.

10. Preservation of inferior parathyroid gland 04'25''

The inferior parathyroid gland is identified and preserved. The very low lateral spread of energy and heat produced by the new Ligasure Precise™ allows to use it even very close to such a delicate structure as a parathyroid gland is.

11. Tracheal plane 05'01''

The tracheal plane is visualized.

12. Second inferior artery branch division 05'18''

Division of a second branch of the inferior thyroid artery and preservation of the superior parathyroid gland are carried out. The recurrent laryngeal nerve is protected with a small sponge.

13. Mobilization from tracheal plane 06'21''

The left thyroid lobe is mobilized from the tracheal plane using the new Ligasure Precise™ as a dissecting and coagulating device.

14. Final nerve check 07'15''

Another check of the integrity of the recurrent laryngeal nerve is undertaken at its entrance point into the larynx.

15. Berry’s ligament division 08'12''

Berry\'s ligament is divided by means of the new Ligasure Precise™.

16. Completion of mobilization 08'29''

The left thyroid lobe is completely mobilized. This is the final view of the operative field.

使用者名稱
密碼
	記得我 (必須啟動Cookies設定)