This minimally invasive approach is safe, likely speeds wound healing and has a superior cosmetic result, according to findings published in the June issue of Laryngoscope.
The study looked at 44 patients with cancerous or benign thyroid disease who had surgery between September 2003 and May 2004 at Medical College of Georgia Medical Center or the Veterans Affairs Medical Center in Augusta. "This is a very straightforward approach in skilled hands that allows us to use smaller incisions while still safely identifying important structures in the area, which are the nerves to the voice box and the parathyroid glands,” says Dr. David J. Terris, Porubsky Professor and chair of the MCG Department of Otolaryngology - Head and Neck Surgery and lead author on the study.
This approach incorporates various techniques to reduce the typical incision size across the base of the neck - from about three to four inches to one to two inches - while still enabling removal of all or part of the peach-sized gland that controls metabolism. Growths on this gland can cause jitters and weight loss.
"We use retractors to get exposure and use telescopes and other laparoscopic instruments that can fit through a small incision then we work off the video screen,” says Dr. Terris. "I send many patients home the day of surgery because it's so much less invasive.”
The minimally invasive approach includes a smaller incision, ligating blood vessels as needed, then cutting through the strap muscles - called the Sofferman technique - to directly access the thyroid. Surgeons use tiny video cameras and endoscopes to work through the incision. Afterward, the strap muscles are repaired and the incision closed with medical-grade glue.
Reduced tissue trauma means less chance of postoperative drainage from the site. Patients may go home the same day or spend one night in the hospital compared to two to three days with the older technique.
MEDICA.de; Source: Medical College of Georgia