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◆要旨:当科では良性の甲状腺腫に対する完全内視鏡下甲状腺切除術においていくつかの工夫を行い,これまでよりも容易な手技と手術時間の短縮を目指してきた.ポートは腋窩に約3cmの皮切から12mmトロカーを1本留置し,さらに前胸部のVネックラインより尾側に5mmポート3本を刺入し,このうち1本は正中としている.患側の前頸筋を横切することにより,甲状腺の広い露出が可能となり,手技が容易となる.正中の5mmポートから鉗子や超音波凝固切開装置を挿入することで,disorientationを防止でき,甲状腺を気管正中線で直線的に切離できる.甲状腺専門施設ではない当院での完全内視鏡下甲状腺手術手技を報告する.
For benign thyroid tumor, we have developed several creative means to perform total endoscopic thyroidectomy more easily and with shorter operative time. A 12-mm trocar port was placed through a 3-cm skin incision in the anterior axilla, and three 5-mm ports were inserted caudal to the V-neck line in the anterior chest, one of which was median. Transverse incision of the strap muscle on the affected side allowed for a wide exposure of the thyroid gland and facilitated the procedure. Insertion of forceps or an ultrasonically activated device through the 5-mm median port prevented disorientation and allowed linear dissection of the thyroid gland at the midline of the trachea. We report a total endoscopic thyroid surgical procedure at our hospital that is not specialized in thyroid tumors.
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