腔镜甲状腺切除术中手术操作空间的应用体会

Experience of the application of operating space in the laparoscopic thyroidctomy

目的探讨腔镜甲状腺切除术中手术操作空间的建立方法。方法 150例甲状腺切除术患者,先用肾上腺素盐水作为"膨胀液"皮下注射,通过乳晕旁小切口,用皮下分离棒穿刺皮下分离胸前皮瓣,然后在腔镜直视下用超声刀补充分离,完成皮下空间的制造。结果皮下手术操作空间的平均制造时间为14.5 min,制造手术空间平均失血量约5 ml。术后胸前皮瓣平坦美观,除有5例切口位于胸骨前正中者疤痕增生明显外,其余病人对外观均较满意。结论这种建立手术操作空间的方法出血少、创伤小,避免了一些传统甲状腺手术的一些缺陷,可推广应用。

Objectives To investagate the way of establishing operating space in the laparoscopic thyroidctomy. Methods A total of 150 patients were underwent aparoscopic thyroidctomy. At first, saline with 0.7 mg of adrenaline（about 200 ml） was injected subcutaneously. Using a special club, the narrow hypodermic passages on chest the was established through a small incision near the areola. Then operating space was formed by using ultrasound sword. Result The average time of establishing operating space was 14.5 min, and the blood loss was 5 ml. Chest skin kept flat and nice after operation. Only 5 of 150 cases were complicated with obvious scar in the front of the sternum, the rest felt satisfied. Conclusion The establishment of operating space in laparoscopic thyroidectomy possesses few blood loss and less trauma, and can be widely used.