Natural orifice surgery on the thyroid gland using totally transoral video-assisted thyroidectomy: report of the first experimental results for a new surgical method: are we going in the right direction?

Abstract Purpose There is no systematic description of primary anatomical landmarks that allow a surgeon to reliably and safely navigate the superior and posterior mediastinum’s fat tissue spaces near large vessels and nerves during video-assisted endothoracoscopic interventions in the prone position of a patient. Our aim was to develop an algorithm of sequential visual navigation during thoracoscopic extirpation of the esophagus and determine the most permanent topographic and anatomical landmarks allowing safe thoracoscopic dissection of the esophagus in the prone position. Methods The anatomical study of the mediastinal structural features was carried out on 30 human cadavers before and after opening the right pleural cavity. Results For thoracoscopic extirpation of the esophagus in the prone position, anatomical landmarks are defined, their variants are assessed, and an algorithm for their selection is developed, allowing their direct visualization before and after opening the mediastinal pleura. Conclusion The proposed algorithm for topographic and anatomical navigation based on the key anatomical landmarks in the posterior mediastinum provides safe performance of the video-assisted thoracoscopic extirpation of the esophagus in the prone position.

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International Multicenter Trial on Clinical Natural Orifice Surgery—NOTES IMTN Study: Preliminary Results of 362 Patients

Surgical Innovation ◽

10.1177/1553350610370968 ◽

2010 ◽

Vol 17 (2) ◽

pp. 142-158 ◽

Cited By ~ 135

Author(s):

Ricardo Zorron ◽

Chinnusamy Palanivelu ◽

Manoel Passos Galvão Neto ◽

Almino Ramos ◽

Gustavo Salinas ◽

...

Keyword(s):

Multicenter Trial ◽

Natural Orifice Surgery ◽

Natural Orifice ◽

Preliminary Results ◽

International Multicenter

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Video-Assisted Implantation of a Left Ventricular Lead and Intrathoracic Tunneling to a Right-Sided CRT-D Device

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0b013e3182372464 ◽

2011 ◽

Vol 6 (5) ◽

pp. 341-343

Author(s):

Thijs Stoker ◽

Theo J. Klinkenberg ◽

Alexander H. Maass ◽

Massimo A. Mariani

Keyword(s):

Left Ventricular ◽

Pleural Space ◽

Left Ventricular Lead ◽

Cardiac Resynchronization ◽

Ventricular Pacing ◽

Video Assisted ◽

Ventricular Lead ◽

Pacing Lead ◽

Left Ventricular Pacing ◽

The Right

We describe two cases in which a biventricular implantable cardioverter defibrillator for cardiac resynchronization therapy had to be placed on the right side due to unsuitability of the left subclavian vein. Endocardial implantation of a left ventricular lead through the coronary sinus was previously attempted but was unsuccessful. Implantation of the epicardial left ventricular pacing lead was performed through video-assisted thoracic surgery on the left side. The connector end of the left ventricular pacing lead was tunnelized through the anterior mediastinum into the right pleural space. The right-sided pocket was then opened. A tunnel was created from the pocket to the thoracic wall, and the pleural space was entered over the second rib. The lead was retrieved from the right pleural space and connected with the Cardiac resynchronization therapy-device (CRT-D). Both procedures and postoperative periods were uneventful. Intrathoracic left-to-right tunneling of an epicardial left ventricular lead by video-assisted thoracic surgery is feasible and safe. It provides an alternative to subcutaneous tunneling.

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Acute thyroiditis after tooth extraction

Kazan medical journal ◽

10.17816/kazmj50602 ◽

1935 ◽

Vol 31 (3-4) ◽

pp. 535-535

Author(s):

E. Auslender

Keyword(s):

Thyroid Gland ◽

Tooth Extraction ◽

Acute Inflammation ◽

Right Lobe ◽

The Right ◽

Acute Thyroiditis

Five days after tooth extraction, a 24-year-old woman developed acute inflammation of the right lobe of the thyroid gland, which after a while spontaneously healed.

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Diagnostic and Therapeutic Performance of Video-Assisted Thoracoscopic Surgery (Vats) in Investigation and Management of Pleural Exudates

Annals of The Royal College of Surgeons of England ◽

10.1308/003588408x318246 ◽

2008 ◽

Vol 90 (7) ◽

pp. 597-600 ◽

Cited By ~ 14

Author(s):

ARL Medford ◽

YM Awan ◽

A Marchbank ◽

J Rahamim ◽

J Unsworth-White ◽

...

Keyword(s):

Diagnostic Yield ◽

Thoracoscopic Surgery ◽

Good Practice ◽

National Standards ◽

Postoperative Fever ◽

Video Assisted ◽

The Right ◽

Culture Negative ◽

Video Assisted Thoracoscopic Surgery ◽

Fluid Culture

INTRODUCTION Video-assisted thoracoscopic surgery (VATS) is the gold standard investigation for diagnosis of pleural exudates. It is invasive and it is important to ensure that it is performed to acceptable national standards. We assumed that VATS empyema fluid culture would not contribute further to microbiological diagnosis in referred culture-negative empyemas. PATIENTS AND METHODS Eighty-six consecutive external referrals for VATS for diagnosis of a cytology-negative pleural exudate (or for further management of the exudate) were studied retrospectively. Diagnostic yield, pleurodesis efficacy and complications were compared to national standards and good practice recommendations. VATS empyema fluid microbiological culture results were compared to pre-VATS empyema fluid culture results. RESULTS VATS was performed well within national standards with a diagnostic yield of 82.3% for cytology-negative exudates, 100% pleurodesis efficacy, 5.8% postoperative fever, with only one significant complication (1.2% rate) and no deaths. Compliance with good practice pleural fluid documentation points was greater than 70%. VATS empyema fluid culture positivity (84.6%) was significantly higher than pre-VATS fluid culture (35%). CONCLUSIONS VATS was performed to acceptable standards. These data confirm the utility and safety of VATS in the right context but also suggest the potential diagnostic utility of VATS empyema fluid culture. Further studies are required to investigate this latter possibility further.

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Intrathyroidal Parathyroid Carcinoma: Report of an Unusual Case and Review of the Literature

Case Reports in Pathology ◽

10.1155/2013/198643 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 6

Author(s):

Lizette Vila Duckworth ◽

William E. Winter ◽

Mikhail Vaysberg ◽

César A. Moran ◽

Samer Z. Al-Quran

Keyword(s):

Thyroid Gland ◽

Parathyroid Carcinoma ◽

Unusual Case ◽

Thyroid Tissue ◽

Parathyroid Tissue ◽

African American Female ◽

Thyroid Lobe ◽

Local Infiltration ◽

Sestamibi Scan ◽

The Right

Intrathyroidal parathyroid carcinoma is an exceedingly rare cause of primary hyperparathyroidism. A 51-year-old African American female presented with goiter, hyperparathyroidism, and symptomatic hypercalcemia. Sestamibi scan revealed diffuse activity within an enlarged thyroid gland with uptake in the right thyroid lobe suggestive of hyperfunctioning parathyroid tissue. The patient underwent thyroidectomy and parathyroidectomy. At exploration, a 2.0 cm nodule in the usual location of the right inferior parathyroid was sent for intraoperative frozen consultation, which revealed only ectopic thyroid tissue. No parathyroid glands were identified grossly on the external aspect of the thyroid. Interestingly, postoperative parathyroid hormone levels normalized after removal of the thyroid gland. Examination of the thyroidectomy specimen revealed a 1.4 cm parathyroid nodule located within the parenchyma of the right superior thyroid, with capsular and vascular invasion and local infiltration into surrounding thyroid tissue. We present only the eighth reported case of intrathyroidal parathyroid carcinoma and review the literature.

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Mediastinal Thyroid Carcinoma and Graves’ Disease: A Rare Presentation

Case Reports in Endocrinology ◽

10.1155/2021/6584616 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

Sara Lomelino Pinheiro ◽

Inês Damásio ◽

Ana Figueiredo ◽

Tiago Nunes da Silva ◽

Valeriano Leite

Keyword(s):

Thyroid Gland ◽

Thyroid Carcinoma ◽

Mediastinal Mass ◽

Kinase Inhibitor ◽

Palliative Radiotherapy ◽

Endobronchial Ultrasound ◽

Antithyroid Drugs ◽

Graves Disease ◽

Rare Presentation ◽

The Right

Background. Mediastinal thyroid carcinoma is extremely rare, with few cases reported in the literature. Case Report. A 73-year-old man presented with weight loss for 6 months. Imaging by computed tomography (CT) documented a large mediastinal mass below the thyroid gland and pulmonary metastases. Neck ultrasound found two spongiform nodules in the right thyroid lobe, and fine-needle aspiration citology (FNAC) of these nodules revealed they are benign. Endobronchial ultrasound-guided needle biopsy of the mediastinal mass was compatible with papillary thyroid cancer. A few weeks later, the patient developed overt hyperthyroidism due to Graves’ disease, which was treated with antithyroid drugs. 99mPertechnetate scintigraphy showed increased diffuse uptake in the thyroid parenchyma but the absence of uptake in the paratracheal mass and in the lung nodules. The patient was not considered eligible for surgical intervention or therapy with tyrosine kinase inhibitor due to tracheal and mediastinal vessel invasion and was treated with palliative radiotherapy. Two months later, restaging PET-FDG showed an intense uptake in the right lobe of the thyroid gland, lymph nodes, lungs, bone, muscle, myocardial, kidney, and adrenal gland. Conclusion. In this case, thyroid carcinoma presented as a mediastinal mass with concurrent hyperthyroidism due to Graves’ disease. Although uncommon, the clinicians should be aware of these situations. Obtaining a prompt histological examination of an intrathoracic mass is crucial to ensure an early diagnosis and treatment.

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