经腋窝单孔甲状腺手术

Trans-axillary Single-incision Endoscopic Thyroidectomy

取腋窝经路达甲状腺区,用电钩或超声刀常规分离,钝性分离暴露出患侧甲状腺。暴露喉返神经及甲状旁腺,显露、游离甲状腺下动静脉,解剖显露喉返神经,紧贴甲状腺被膜用超声刀凝固切断甲状腺下动静脉及甲状腺中静脉,注意勿损伤喉返神经及甲状旁腺。将甲状腺向上向内侧翻转,从后面暴露甲状腺上动脉。游离上极血管用超声刀凝固切断之,超声刀切除病灶及腺体,从腋窝切口取出标本,置入引流管。

A surgical pathway from the axilla to the thyroid region was used to dissect the infrahyoid muscles from the medial part of the sternocleidomastoid muscle. The thyroid on the lesion side was exposed by blunt dissection. The recurrent laryngeal nerve and the parathyroid was exposed. The arteries and veins under the thyroid were exposed and dissected by an ultrasound knife. Dissection was continued to preserve the recurrent laryngeal nerve and parathyroid gland. The thyroid was medially rolled so that the superior thyroid artery was identified from behind. Then the superior blood vessels were dissected by an ultrasound knife. The gland was incised with a harmonic scalpel. Based on the circumstances observed during the surgery, the specimen was put into a bag, retrieved through the incision, and finally a drainage tube was placed subcutaneously .