Marescaux J, Vix M, Soler L. Virtual reality applied to video-assisted left superior parathyroidectomy. Epublication: WeBSurg.com, Nov 2006;6(11). URL: http://www.websurg.com/ref/doi-vd01en2011.htm

Virtual reality applied to video-assisted left superior parathyroidectomy

Add to my favorite list

Lien TDM:

Chirurgie endocrinienne > Glandes parathyroïdes > Hyperparathyroïdie > Parathyroïdectomie vidéo-assistée

J Marescaux (France), M Vix (France), L Soler (France)

November 2006

English - 04'30''

This video demonstrates how virtual reality is applied to video-assisted left superior parathyroidectomy. The virtual reconstruction is done from a preoperative contrast CT scan. The anatomy is then recreated layer by layer starting from the skin to the bone. Every anatomical structure can be removed or added back, in order to visualize areas that are normally not easily accessible and therefore difficult to identify. The relation with the adjacent vascular structures, arteries and veins, can also be very precisely established. A two cm horizontal neck incision is made below the sternal notch. The surgeons demonstrates a careful dissection of the anterior and lateral aspect of the thyroid. This manoeuvre allows to easily reach the area that had been previously virtually reconstructed. Once the gland is freed from its attachment the vascular pedicle is identified, isolated and clipped.

Regarder la vidéo

00'12''	Patient history Video-assisted approach for hyperparathyroidism needs precise and reliable landmarks prior to surgery. This reconstruction is done starting from a preoperative control CT-scan.
00'23''	3D reconstruction of the neck The anatomy is then rebuilt layer by layer starting from the skin to the bones. Every structure can be removed or added back in order to visualize areas that are normally not easily accessible and therefore difficult to identify. When the spine disappears from the image, the posterior aspect of the thyroid can be visualized and the parathyroid adenoma becomes evident.
00'57''	Localization of parathyroid adenoma This reconstruction is particularly helpful to detect posterior adenomas in the case of this supra-posterior adenoma migrated deeply in the tracheo-esophageal groove. The image is then verified comparing the virtual reconstruction with the CT-scan horizontal and sagittal cuts. The relation with the adjacent vascular structures, arteries and veins can also be very precisely established.
01'35''	Start of procedure A 2cm horizontal neck incision is made above the sternal notch and allows a precise dissection of the anterior and lateral aspect of the thyroid. The virtual reconstruction of the patient’s neck facilitates the surgeon to operate a very small area of the neck rather than exposing the entire neck and both sides of the thyroid.
02'04''	Finding the parathyroid adenoma This dissection allows to quickly reach the area that had been previously virtually reconstructed. When the parathyroid adenoma is identified it must be carefully handled to avoid damaging the parathyroid capsule. The gland can be retracted bluntly by pushing it medially better exposing it. While retracting maneuvers provide tension, a curved hook dissector is used to dissect the gland away from surrounding structures and loose areolar tissue until complete mobilization is achieved.
03'06''	End of procedure Gentle operative manipulation and careful dissection allows to free the gland from its attachments and to clearly identify the vascular pedicle that is isolated and clipped. Advances in minimally invasive surgery in the treatment of hyperparathyroidism have increased the relevance of preoperative diagnostic imaging. The virtual reconstruction of the patient’s neck allows an ideal preoperative simulation. The size of the adenoma corresponds to the measurements taken during virtual reconstruction.

Tous les médias de:

Jacques Marescaux

Michel Vix

Luc Soler

Toutes les vidéos chirurgicales sur le même sujet

Chirurgie endocrinienne > Glandes parathyroïdes > Hyperparathyroïdie > Parathyroïdectomie vidéo-assistée

Video-assisted parathyroidectomy: left inferior adenoma	P Miccoli	2003 Feb
Video-assisted parathyroidectomy: right superior adenoma	P Miccoli	2003 Feb
Video-assisted parathyroidectomy for primary hyperparathyroidism	P Miccoli	2001 Nov
Video-assisted parathyroidectomy	P Berti, P Miccoli	2004 Sep
Video-assisted right parathyroidectomy for parathyroid adenoma	P Miccoli	2004 Sep
Virtual reality applied to video-assisted left superior parathyroidectomy	J Marescaux, M Vix, L Soler	2006 Nov
Minimally invasive video-assisted right parathyroidectomy for hyperparathyroidism	M Vix, J Marescaux	2007 Nov
微創影像輔助右副甲狀腺切除治療副甲狀腺機能亢進	M Vix, J Marescaux	2007 Nov
Paratiroidectomía derecha mínimamente invasiva por hiperparatiroidismo	M Vix	2007 Nov
Minimally invasive video-assisted parathyroidectomy with augmented reality	M Vix, L Soler, J D'Agostino, J Marescaux	2008 Dec
Parathyroïdectomie mini-invasive vidéo-assistée à l’aide de la réalité augmentée	M Vix, L Soler, J D'Agostino, J Marescaux	2008 Dec
Paratiroidectomía video-asistida con realidad aumentada	M Vix, L Soler, J D'Agostino, J Marescaux	2008 Dec
Minimally invasive video-assisted parathyroidectomy for primary hyperparathyroidism	M Vix, L Soler, J Marescaux	2009 Mar
Minimally invasive video-assisted parathyroidectomy for primary hyperparathyroidism	P Miccoli, M Vix, L Soler, J Marescaux	2009 Mar
Paratiroidectomía mínimamente invasiva video asistida, para un hiperparatiroidismo primario	M Vix, L Soler, J Marescaux	2009 Mar

Haut de page

This website is certified by Health On the Net Foundation. Click to verify.

WeBSurg Members