Bilateral oblique approach to parathyroid glands
| Autor: | Roger Sarrazin, Pierre-Yves Brichon, Philippe Chaffanjon |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Parathyroidectomy
Adult Male medicine.medical_specialty Adolescent medicine.medical_treatment Infrahyoid muscles Parathyroid Glands medicine Multiple Endocrine Neoplasia Type 1 Humans Local anesthesia Aged Aged 80 and over Hyperparathyroidism business.industry Thyroid Middle Aged medicine.disease Surgery Endocrine surgery Dissection medicine.anatomical_structure Parathyroid Neoplasms Treatment Outcome Advances in Surgical Technique Linea alba (abdomen) Female Hyperparathyroidism Secondary business |
| Zdroj: | Annals of surgery. 231(1) |
| ISSN: | 0003-4932 |
| Popis: | Since Cope in 1941, the surgical approach to the parathyroid glands has generally used the same transverse low cervicotomy used for cervical endocrine surgery. 1 Exposure of the dorsal part of the thyroid lobe is difficult during this dissection because of the adhesions between the infrahyoid muscles and the capsule of the thyroid gland. Esselstyn 2 and Chigot 3 transversally cut these muscles; Edis, 4 Proye, 5, and Demard 6 opened the linea alba of the neck and separated the left and right muscles. In 1975, Dubost proposed to go around the lateral edge for reoperations in hyperparathyroidism. 7 Stevens proposed it for all surgical approaches to parathyroid glands. 8 Chapuis performed a unilateral approach under local anesthesia, guided by preoperative localization and intraoperative biologic monitoring; this approach requires a transverse or oblique skin incision and a transverse incision of the infrahyoid muscles. 9 More recently, endoscopic procedures have been introduced with or without carbon dioxide insufflation to perform the same unilateral exploration. 10,11 Only a few authors perform videocervicoscopy for this indication; the results of these preliminary studies and initial experience are presented here. It is possible to avoid infrahyoid dissection by using a double lateral approach that gives direct, specific, and bloodless access. We have used this technique since 1976, and it has been applied since 1978 to all the operations for hyperparathyroidism in the Service de Chirurgie Generale et Thoracique. We describe here the surgical technique of a minimally invasive parathyroidectomy with a complete neck exploration and its anatomic basis as an alternative method of the endoscopic approach. |
| Databáze: | OpenAIRE |
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