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Nakajo A, Minami K, Shinden Y, Toda H, Hirashima T, Nagata A, Nomoto Y, Maemura K, Natsugoe S. Upgraded bidirectional approach video-assisted neck surgery (BAVANS) using a rigid endoscope with variable viewing direction for advanced endoscopic lymph node dissection in thyroid cancer patients. Surg Today 2019; 50:778-782. [PMID: 31691138 PMCID: PMC7305093 DOI: 10.1007/s00595-019-01909-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 10/01/2019] [Indexed: 11/29/2022]
Abstract
In 2011, we developed bidirectional approach video-assisted neck surgery (BAVANS) for endoscopic thyroid cancer surgery. BAVANS combines two different approach pathways at 180 degrees to the cervical lesion for endoscopic thyroidectomy and complete cervical lymphadenectomy. We reported previously that the cranio-caudal approach is extremely useful for endoscopic complete lymph node dissection around the trachea. In 2014, we upgraded the initial BAVANS for better maneuverability and quality of lymph node dissection. A new high-tech rigid endoscope with a variable viewing direction (EndoCAMeleon™), has enabled us to reduce the camera port in the anterior neck while keeping the easy maneuverability and the same quality of central lymph node dissection (LND) as with the initial BAVANS. Endoscopic thyroid cancer surgery is now evolving concurrently with new visual technology.
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Affiliation(s)
- Akihiro Nakajo
- Department of Surgical Oncology, Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima, 890-0075, Japan.
| | - Koji Minami
- Department of Surgical Oncology, Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima, 890-0075, Japan
| | - Yoshiaki Shinden
- Department of Surgical Oncology, Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima, 890-0075, Japan
| | - Hiroko Toda
- Department of Surgical Oncology, Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima, 890-0075, Japan
| | - Tadahiro Hirashima
- Department of Surgical Oncology, Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima, 890-0075, Japan
| | - Ayako Nagata
- Department of Surgical Oncology, Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima, 890-0075, Japan
| | - Yuki Nomoto
- Department of Surgical Oncology, Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima, 890-0075, Japan
| | - Kosei Maemura
- Department of Surgical Oncology, Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima, 890-0075, Japan
| | - Shoji Natsugoe
- Department of Surgical Oncology, Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima, 890-0075, Japan
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The Learning Curve of Transareola Single-site Laparoendoscopic Thyroidectomy: CUSUM Analysis of a Single Surgeon's Experience. Surg Laparosc Endosc Percutan Tech 2016; 26:364-367. [PMID: 27552376 PMCID: PMC5054955 DOI: 10.1097/sle.0000000000000309] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Transareola single-site laparoendoscopic thyroidectomy (TASSET) is a rapidly advancing minimally invasive procedure. The purpose of this study was to evaluate the learning curve for TASSET.
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Subcutaneous dissection area contributes less to endoscopic thyroidectomy-related invasiveness. Surg Endosc 2016; 30:4272-8. [PMID: 26743105 DOI: 10.1007/s00464-015-4742-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 12/21/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To clarify the contribution of the subcutaneous area during breast approach endoscopic thyroidectomy (BAET), with regard to invasiveness-related outcomes. METHODS Seventy-two patients were randomly assigned to two groups: standard dissection and limited dissection. Postoperative pain and inflammatory response were compared between groups. RESULTS The groups were well matched except for subcutaneous dissection area (137.11 ± 21.10 vs. 83.69 ± 12.10 cm(2), p < 0.0001). No significant difference was found with regard to VAS score and postoperative inflammatory response. CONCLUSION Our RCT indicated that the subcutaneous area plays a less important role with regard to BAET-related postoperative pain.
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