WebSurg中文版尚未完成，翻譯工作進行中！

Video-assisted parathyroidectomy

WebSurg是個虛擬大學，可在世界各地透過網路取得。我們的目標是提供外科醫師、科學協會及醫學產業第一個腹腔鏡及其最新發展之線上持續醫學教育的平台，包括NOTES和機器人手術。

瀏覽全世界
虛擬大學
繁體中文 ▼

Video-assisted   parathyroidectomy

作者群
P Berti, P Miccoli
關鍵字
parathyroidectomy,operation,endocrinology,video assisted,parathyroid glands,resection
媒體類型
期間
06'00''
刊物
2004-09
普通的
最愛
Favorites Media
音訊
en
副標題
en
數位出版
WeBSurg.com, Sept 2004;4(09).
URL: http://www.websurg.com/doi-vd01en1176e.htm

Video-assisted   parathyroidectomy

1. Case presentation 00'40''
The operation starts with a 1.5cm skin incision, 2cm above the sternal notch. The skin tissue is dissected to reach the plane of the strap muscles, looking for the midline. This is not an ideal case for video-assisted parathyroidectomy because the patient has got a short and fat neck and the lesion is not very well localized. We have found the midline and we open it as much as possible over a length to 2 to 4cm. We are on the side in which the adenoma is supposed to be and we start dissecting the thyroid lobe from the strap muscles in order to see the carotid artery, which is one of the most important landmarks of this step. This man also has got thyroid nodules, he has a small multinodular goitre. This is the middle thyroid vein. The dissection is done with small instruments such as spatulas or an aspirator with a spatula shape that allows dissection and aspiration at the same time. The parathyroid adenoma was described as a 1.5cm lesion lying very posterior, so we are trying to reach the posterior plane. Now we cut the branch of the inferior thyroid artery. After having cut some small vessels, we are going towards the upper pedicle on the posterior plane, looking for the upper right parathyroid. You see now the esophagus is almost completely freed on the upper part of the operative space and we go down. This is the posterior plane, the bone plane, no adenoma is present in this space. This should be the pedicle of the adenoma; there are small lymphatic vessels on the left and we can cut them without any clips, they will not bleed. This is a 1.5cm long and 1cm large parathyroid adenoma. The color is suggestive. We do the final check of the operative field.