Diseases of the thyroid gland
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Miniinvasive video-assisting partial thyroidectomy, using axillary access and transmammary access
The author: Martin Strik
Miniinvasive video-assisting partial thyroidectomy, using axillary access and transmammary access.
Professor Martin Strik (Germany) is performing an operation (2012).
In this film the technique of miniinvasive video-assisting partial thyroidectomy via axillary and transmammary accesses in a 27 year-old female patient with the left nodular euthyroid goiter, degree 2. At the first stage a longitudinal 2 cm incision is done along the anterior edge of the greater pectoral muscle. Then on the right along the internal surface of the axillary space in subcutaneous fat until the jugular area the tunnel is formed. A 10 mm troacar is set up. Then suprareolar 0.5 cm incision is done from both sides. Tunnels are formed having acute and obtuse angles until the jugular incisure in subcutaneous fat. 5 mm troacars are introduced and 30 g optics. The subcutaneous muscle is mobilized, starting from the prethyroid muscle and jugular incisure until the superior edge of thyroid cartilages. Dissection of tissues is done by means of a 5 mm instrument Harmonic Scalpel Ethicon. The left group of the prethyroid muscles is mobilized without transection. The left lobe of the gland is exposed, it is increased due to the nodular formation near the lower pole up to 2 cm. Hemithyroidectomy on the left is performed with the visualization of recurrent laryngeal nerve on the left and clipping of vessels of the area where nerves originate. Then hemostasis is checked. Atraumatic sutures are placed for stitching prethyroid muscles, Vicril 3-0 thread is used. Troacars are removed.