J Korean Med Assoc.  2003 Aug;46(8):701-707. 10.5124/jkma.2003.46.8.701.

Minimally Invasive Surgery in Endocrine Surgical Diseases

• Chung WY

• KMID: 2183109
• DOI: http://doi.org/10.5124/jkma.2003.46.8.701

Abstract

The concept of minimally invasive endocrine surgery is the newest and most interesting field of surgery. Endocrine surgery is well suited to minimally invasive technique because the nature of most endocrine operations involves a total or partial resection of a gland and reconstructive surgery is rarely necessary. The minimally invasive thyroid procedure can be classified into endoscopic technique with or without constant gas insufflation, video-assisted technique performed under direct and endoscopic vision, and minimally invasive open technique. The endoscopic technique can be subclassified into a neck approach, anterior chest approach, breast approach, and axillary approach. Each of these techniques has its own advantages in terms of cosmetic results, invasiveness, safety, and ease of use. With experience and more advanced devices, minimally invasive thyroid surgery can replace the traditional procedure for most patients. The advances in diseased parathyroid gland and removal make surgical removal for primary hyperparathyroidism simpler and faster. Various types of minimally invasive parathyroid surgery (endoscopic technique, video-assisted technique, radio-guidance technique, and focused parathyroidectomy) are now performed and have replaced traditional exploration for most patients. The adrenal surgery is well suited for laparoscopic removal due to their relatively small size and the low incidence of malignancy. Since its first description in 1992 by Gagner and associates, the laparoscopic adrenalectomy has become the gold standard for the treatment of most benign adrenal tumors and can give more benefits to the patients with advanced surgical skills and laparoscopic instruments.

Keyword

Minimally invasive endocrine surgery; Endoscopic

MeSH Terms

Adrenalectomy
Breast
Humans
Hyperparathyroidism, Primary
Incidence
Insufflation
Neck
Parathyroid Glands
Surgical Procedures, Minimally Invasive*
Thorax
Thyroid Gland

Reference

1. Huscher CSG, Chiodini S, Napolitano C, Recher A. Endoscopic right thyroid lobectomy. Surgical Endoscopy. 1997. 11:877.

2. Park CS, Chung WY, Chang HS. Minimally Invasive Open Thyroidectomy. Surgery Today. 2001. 31:665–669.

3. Ferzli GS, Sayad P, Abdo Z, Caccione RN. Minimally invasive, nonendoscopic thyroid surgery. J Am Coll Surg. 2001. 192(5):665–668.

4. Shimizu K, Akira S, Tanaka S. Video-Assisted Neck Surgery : endoscopic resection of benign thyroid tumor aiming at scaless surgery on the neck. J Surg Oncol. 1998. 69:178–180.

5. Bellantone R, Lombardi CP, Rubino F, Perilli V, Sollazzi L, Gagner M, et al. Arterial PCO2 and cardiovascular function during endoscopic neck surgery with carbone dioxide insufflation. Arch Surg. 2001. 136:822–827.

6. Inabnet WB III, Gagner M. Gagner M, Inabnet WB, editors. Endoscopic thyroidectomy : supraclavicular approach. Minimally invasive endocrine surgery. 2002. Lippincott Williams and Williams;45–54.

7. Takami HE, Ikeda Y. Gagner M, Inabnet WB, editors. Endoscopic thyroidectomy via axillary or anterior chest approach. Minimally invasive endocrine surgery. 2002. Lippincott Williams and Williams;55–63.

8. Ohgami M, Ishii S, Arisawa Y, Ohmori T, Noga K, Kitajima M, et al. Scaless endoscopic thyroidectomy : breast approach for better cosmetics. Surg Laparosc Endosc Percutan Tech. 2000. 10:1–4.

9. Ikeda Y, Takami H, Sasaki Y, Kan S, Niimi M. Endoscopic neck surgery by the axillary approach. J Am Coll Surg. 2000. 191:336–340.

10. Gupta VK, Yeh KA, Burke GJ, Wei JP. 99m-Technetium sestamibi localized solitary parathyroid adenoma as an indication for limited unilateral surgical exploration. Am J Surg. 1998. 176:409–412.

11. Carty SE, Worsey J, Virji MA, Brown ML, Watson CG. Concise parathyroidectomy ; the impact of preoperative SPECT 99m-Tc sestamibi scanning and intraoperative quick parathyroid hormone assay. Surgery. 1997. 122:1107–1116.

12. Sackett WR, Barraclough B, Reeve TS, Delbridge LW. Worldwide trends in the surgical treatment of primary hyperparathyroidism in the era of minimally invasive parathyroidectomy. Arch Surg. 2002. 137:1055–1059.

13. Miura D, Wada N, Arici C, Morita E, Duh QY, Clark OH. Does intraoperative qoick parathhyroid hormone assay improve the result of parathyroidectomy. World J Surg. 2002. 26:926–930.

14. Jaskowiak NT, Sugg SL, Helke J, Koka MR, Kaplan EL. Pitfalls of intraoperative quick parathyroid hormone monitoring and Gamma probe localization in surgery for primary hyperparthyroidism. Arch Surg. 2002. 137:659–669.

15. Agarwal G, Barakate MS, Robinson B, Wilkinson M, Barraclough B, Delbridge LW, et al. Intraoperative quick parathyroid hormone versus same day parathyroid hormone testing for minimally invasive parathyroidectomy : a costeffectiveness study. Surgery. 2001. 130:963–970.

16. Gagner M. Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism. Br J Surg. 1996. 83:875.

17. Gauger PG, Reeve TS, Delbridge LW. Endoscopically assisted, minimally invasive parathyroidectomy. Br J Surg. 1999. 86:1563–1566.

18. Norman J, Chheda H, Farrel C. Minimally invasive parathyroidectomy for primary hyperparathyroidism ; decreasing operative time and potential complications while improving cosmetic results. Am Surgeon. 1998. 64:391–396.

19. Norman J, Denham D. Minimally invasive radioguided parathyroidectomy in the reoperative neck. Surgery. 1998. 124:1088–1093.

20. Gagner M, Lacroix A, Bolte E, Pomp A. Laparoscopic adrenalectomy : The importance of flank approach in the lateral decubitus position. Surg Endosc. 1994. 8:135–138.

21. Gagner M. Laparoscopic adrenalectomy. Surg Clin North Am. 1996. 76:523–537.

22. Gagner M, Pomp A, Heniford T, Pharand D, Lacroix A. Laparoscopic adrenalectom : lessons learned from 100 consecutive procedures. Ann Surg. 1997. 226:238–247.

23. Stuart RC, Chung SCS, Lau JYW, Chan ACW, Cockram CS, Li AKC, et al. Laparoscopic adrenalectomy. Br J Surg. 1995. 82:1498–1499.

24. Parrilla P, Lujan JA, Rodrigues JM, Robles R, lrrana J. Initial experience with endoscopic retroperitoneal adrenalectomy. Br J Surg. 1996. 83:987–988.

25. Gagner M, Garcia-Ruiz A. Thecnical aspects of minimally invasive abdominal surgery performed with needlescopic instruments. Surg Laparosc Endosc. 1998. 8:171–179.