 |
Related Articles |
Transoral endoscopic neck surgery: feasibility and safety in a porcine model based on the example of thymectomy.
Surg Endosc. 2010 Aug 24;
Authors: Wilhelm T
BACKGROUND: In anatomical studies and cadaver dissections, we developed an endoscopic transoral access to the anterior neck region to reduce surgical access trauma. Through a sublingual trocar and two additional trocars in the vestibule of the oral cavity, the pretracheal and thyroid region was reached with standard laparoscopic instruments. METHODS: We conducted an experimental trial in five pigs under general anesthesia to estimate the safety and feasibility of the method; via this approach, the thymus was partially resected. Perioperative antibiotics were administered but analgesics were not given in the postoperative course. Oral intake and behavior were observed during the following 2 days. After necropsy, examination of the access route took place by means of dissections. The tissue surrounding the working trocar was histologically examined. RESULTS: The pretracheal region could be reached without a problem and the procedure was performed almost “bloodlessly” in an anatomically defined layer. The intervention time decreased successively. Postoperative awakening was uneventful. Regular oral food intake was observed after 2-3 h. Pain reactions were not registered during the entire postoperative phase. After dissection, all relations appeared inconspicuous (no infections, fresh/old hematoma). Two local encapsulated seromas were observed. Histologically, only a mild tissue reaction was noted. CONCLUSION: In this study, the endoscopic transoral approach to minimally invasive neck surgery seemed safe and feasible. Minimally invasive endoscopic procedures in the anterior neck region could be a possible application of this new approach.
PMID: 20734070 [PubMed - as supplied by publisher]