World Journal of Laparoscopic Surgery

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VOLUME 3 , ISSUE 3 ( September-December, 2010 ) > List of Articles

RESEARCH ARTICLE

Endoscopic Right Lobectomy Axillary-breast Approach: Report of Two Cases

Nina Irawati

Citation Information : Irawati N. Endoscopic Right Lobectomy Axillary-breast Approach: Report of Two Cases. World J Lap Surg 2010; 3 (3):109-112.

DOI: 10.5005/jp-journals-10007-1093

Published Online: 01-12-2010

Copyright Statement:  Copyright © 2010; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background

We report our two initial experiences in the treatment of thyroid disease with endoscopic thyroidectomy. Minimally invasive video-assisted thyroidectomy (MIVAT) was initially introduced by Miccoli. The modification was made by using axillary and breast approach with CO2 insufflation.

Method

A young woman patient with 5 cm right lobe thyroid disease, suspected benign. From physical examination, sonography and FNAB findings were categorized as benign case. Thyroid function test was within normal limit. She was operated with endoscopic right lobectomy. The procedure was carried out through incision of 5-10 mm axillary and breast. The right lobectomy procedure was performed by dedicated instrument. No drain needed. The pathology result was follicular carcinoma, so further treatment needed. Other patient, a woman with 4 cm right lobe thyroid cyst. FNAB proved benign, was operated with the same procedure, and pathology result was benign cyst.

Result

Duration of first operation was 300 minutes and the second one was 120 minutes, minimal blood loss, and no major complication. Patients were discharged 24 hours after operation. Cosmetic results and postoperative pain were excellent. Slight swelling on their necks was found and reduced after 48 hours. Pain around shoulder until day-7 postoperation and significantly disappeared after 10 days.

Conclusion

We reported two cases, which were operated by endoscopic right lobectomy as a safe, reproducible technique with an indication in a minority of patients/candidates to thyroidectomy and is characterized by a better postoperative discomfort. The duration of operation would be a curve learning for each surgeon who wishes to perform it.


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