送気法と吊り上げを併用した内視鏡下甲状腺切除術

Endoscopic thyroidectomy with combined air feeding method and lifting

◆要旨：内視鏡下甲状腺手術の利点は創部を前頸部から移動させることによる整容性の向上である．筆者らは内視鏡下甲状腺手術において，より整容性の向上を目指した吊り上げ併用の腋窩法による手術を経験したので手術手技の要点を報告する．操作は腋窩部より2ポート，乳頭部より1ポートを留置し3ポートで送気法を用いて施行した．手術スペース確保に前頸部皮下および前頸筋の吊り上げを併用した．術後合併症は認めなかった．視野確保に特別な器具を使う必要がなく，内視鏡による拡大視効果により直視下の手術と同様に安全に手術を行うことが可能である．

The advantage of endoscopic thyroid surgery is the improvement of cosmesis by moving the wound from the anterior neck. We performed surgery aimed at better cosmesis by using the axillary method with the lifting in combination. We report the main points of the surgical procedure. With this technique,　the entire operation was conducted through 3 ports and we used the air delivery method and lifting of the anterior cervical subcutaneous and anterior cervical muscles to secure an operation space. Postoperative complications were not observed. It is unnecessary to use a special instrument to secure the field of vision and it is possible to carry out the surgery safely as with the operation under direct sight by the magnified visual effect of the endoscope.