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Surg Endosc. 2011 Jun;25(6):1741-6. doi: 10.1007/s00464-010-1305-6. Epub 2010 Aug 24.

Transoral endoscopic neck surgery: feasibility and safety in a porcine model based on the example of thymectomy.

Author information

1
Department of Otolaryngology, Head/Neck and Facial Plastic Surgery, HELIOS Kliniken Leipziger Land, HELIOS Klinikum Borna, Rudolf-Virchow-Straße 2, 04552, Borna, Germany. thomas.wilhelm@helios-kliniken.de

Erratum in

  • Surg Endosc. 2011 Jun;25(6):1747. Benhidjeb, Tahar [added].

Abstract

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
DOI:
10.1007/s00464-010-1305-6
[Indexed for MEDLINE]

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