Modern technologies in thyroid surgery – an overview of the benefits

2019 ◽  
Vol 91 (Suplement 1) ◽  
pp. 5-11
Author(s):  
Marcin Barczyński ◽  
Małgorzata Stopa-Barczyńska ◽  
Aleksander Konturek
Keyword(s):  
Thyroid Surgery ◽  
Near Infrared ◽  
Infrared Imaging ◽  
Endoscopic Thyroidectomy ◽  
Early Discharge ◽  
Endoscopic Thyroid Surgery ◽  
Quality Of Surgery ◽  
Pubmed Database ◽  
Modern Technologies

Utilization of modern technologies in thyroid surgery is increasing. The aim of this paper was to present the up-to-data use of modern technologies in thyroid surgery with special emphasis put on their potential influence on minimized risk of surgeryrelated morbidity and improved quality of surgery. Authors searched PubMed database using the following search terms: modern technologies AND/OR thyroid surgery AND/ OR transoral endoscopic thyroidectomy AND/OR neuromonitoring AND/OR parathyroid preservation AND/OR energybased hemostasis. Of 1678 publications identified 826 were found to be consistent with the aim of this review. The relevant papers addressed the following issues: neuromonitoring in minimization of risk of laryngeal nerves injury (62%), intraoperative iPTH monitoring in preselection of patients for early discharge or onset of substitution with calcium (21.5%), narrow-band and near infrared imaging for identification of parathyroids (5.7%), parathyroids angiography with indcyianine green for parathyroids vascularity assessment (5.5%), transoral endoscopic thyroid surgery via vestibular approach for improvement of cosmetic effects (4.1%), energy-based devices for surgical hemostasis (1.2%). Modern technologies are primarily designed to improve the safety and quality of thyroid surgery, and only then to optimize the cosmetic effects and reduce the time of surgery.

scholarly journals Comparing quality of life between patients undergoing trans-areola endoscopic thyroid surgery and trans-oral endoscopic thyroid surgery

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shuang Shen ◽  
Xiaochi Hu ◽  
Rui Qu ◽  
Youming Guo ◽  
Libo Luo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Thyroid Surgery ◽  
Short Form ◽  
Endoscopic Thyroidectomy ◽  
Operation Time ◽  
Endoscopic Thyroid Surgery ◽  
Sf 36 ◽  
Areola Approach ◽  
High Level

Abstract Background Compared with conventional open surgery, endoscopic thyroidectomy via the oral vestibular approach (ETVOA) and endoscopic thyroidectomy via the areola approach (ETAA) avoided scarring of the skin, which may help patients achieve a better quality of life (QOL). However, the benefit of the QOL from this technique has not been adequately investigated, therefore this study compared the QOL outcomes between ETVOA and ETAA. Methods 131 patients were enrolled in this study. ETAA surgery and ETVOA surgery were performed in 74 patients and 57 patients, respectively. These patients were followed up at 2 weeks, 4 weeks, and 8 weeks, and their QOL was evaluated using a thyroid surgery-specific questionnaire and a short-form health survey (SF-36). Results There were no differences in clinical characteristics such as gender, age, body mass index (BMI), and tumor size between the two groups. The volume of intraoperative blood loss, cost of hospitalization, and complications between the two procedures showed no differences. Compared with ETAA, ETVOA has a longer operation time, no drainage, and shorter hospital stay. In the QOL questionnaire, several parameters in ETVOA were better. The satisfaction scores of patients undergoing ETVOA were higher. In addition, the cosmetic satisfaction in patients who received ETOVA was significantly better than that of patients who underwent ETAA. The degree of neck movement disorder in patients with ETVOA was milder. Patients who received ETVOA had higher score on the SF-36. Conclusions The trans-oral endoscopic approach can acquire better cosmetic results and achieved high-level QOL.

scholarly journals Trans-Oral Endoscopic Thyroid Surgery and Trans-Areola Endoscopic Thyroid Surgery: Which Offers A Better Quality of Life?

2020 ◽  
Author(s):  
Shuang Shen ◽  
Xiaochi Hu ◽  
Rui Qu ◽  
Youming Guo ◽  
Libo Luo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Thyroid Surgery ◽  
Short Form ◽  
Endoscopic Thyroidectomy ◽  
Operation Time ◽  
Endoscopic Thyroid Surgery ◽  
Sf 36 ◽  
Areola Approach ◽  
High Level

Abstract Background: Endoscopic thyroidectomy via the oral vestibular approach (ETVOA) and endoscopic thyroidectomy via the areola approach (ETAA) are becoming more favored in China. Compared with conventional open surgery, both methods avoid the scarring on the neck, but only ETVOA obviates scarring of the skin, which may helps patients achieve a better quality of life (QOL). However, the benefit of the QOL from this technique has not been adequately investigated, therefore this study compared the QOL outcomes between ETVOA and ETAA. Methods: We enrolled 131 patients in this study. ETAA surgery and ETVOA surgery were performed in 74 patients and 57 patients, respectively. These patients were followed up at 2 weeks, 4 weeks, and 8 weeks, and their QOL was evaluated using a thyroid surgery-specific questionnaire and a short-form health survey (SF-36). Results: There were no differences in clinical characteristics such as gender, age, body mass index (BMI), and tumor size between the two groups. The volume of intraoperative blood loss, cost of hospitalization, and complications between the two procedures showed no differences. Compared with ETAA, ETVOA has a longer operation time, no drainage, and shorter hospital stay. In the QOL questionnaire, several parameters in ETVOA were better. The satisfaction scores of patients undergoing ETVOA were higher. In addition, the cosmetic satisfaction in patients who received ETOVA was significantly better than that of patients who underwent ETAA. The degree of neck movement disorder in patients with ETVOA was milder. Patients who received ETVOA had higher score on the SF-36. Conclusions: Compared with ETAA, ETVOA can acquire better cosmetic results and make patients quick return to normal life.Patients who underwent ETVOA achieved high-level QOL.

scholarly journals Comprehensive Review of Fluorescence Applications in Gynecology

2021 ◽  
Vol 10 (19) ◽  
pp. 4387
Author(s):  
Joanna Polom ◽  
Leszek Kalinowski ◽  
Michele Diana ◽  
Manish Chand ◽  
Carmela Caballero ◽  
...  
Keyword(s):  
Cancer Detection ◽  
Near Infrared ◽  
Infrared Imaging ◽  
Safety Issues ◽  
Guided Surgery ◽  
Fluorescence Guided Surgery ◽  
Margin Detection ◽  
New Applications ◽  
Improve Patient

Since the introduction of indocyanine green (ICG) as a fluorophore in near-infrared imaging, fluorescence visualization has become an essential tool in many fields of surgery. In the field of gynecology, recent new applications have been proposed and found their place in clinical practice. Different applications in gynecology were investigated, subcategorized, and overviewed concerning surgical applications and available dyes. Specific applications in which fluorescence-guided surgery was implemented in gynecology are described in this manuscript—namely, sentinel node biopsy, mesometrium visualization, angiography of different organs, safety issues in pregnant women, ureters visualization, detection of peritoneal metastases, targeted fluorophores for cancer detection, fluorescent contamination hysterectomy, lymphography for lower limb lymphedema prevention, tumor margin detection, endometriosis, and metastases mapping. With evolving technology, further innovative research on the new applications of fluorescence visualization in cancer surgery may help to establish these techniques as standards of high-quality surgery in gynecology. However, more investigations are necessary in order to assess if these innovative tools can also be effective to improve patient outcomes and quality of life in different gynecologic malignancies.

scholarly journals Intraoperative Autofluorescence and Indocyanine Green Angiography for the Detection and Preservation of Parathyroid Glands

2020 ◽  
Vol 9 (3) ◽  
pp. 830 ◽  
Author(s):  
Marco Stefano Demarchi ◽  
Wolfram Karenovics ◽  
Benoît Bédat ◽  
Frédéric Triponez
Keyword(s):  
Thyroid Surgery ◽  
Near Infrared ◽  
Infrared Imaging ◽  
Parathyroid Tissue ◽  
Parathyroid Glands ◽  
Endocrine Surgery ◽  
Near Infrared Imaging ◽  
Postoperative Hypoparathyroidism

Fluorescence imaging is a well-known method for both the in vivo and in vitro identification of specific cells or tissues. This imaging tool is gaining importance in the intraoperative detection and preservation of parathyroid glands during endocrine surgery owing to the intrinsic properties of parathyroid tissue. The aim of this paper is to provide an overview of the basics of the technology, its history, and the recent surgical intraoperative applications of near-infrared imaging methods. Moreover, a literature review of the utilization of fluorescence devices in thyroid surgery suggests that the use of near-infrared imaging seems to be beneficial in reducing postoperative hypoparathyroidism, which is one of the most frequent complications of thyroid surgery.

scholarly journals Comparison of quality of life between patients undergoing trans-oral endoscopic thyroid surgery and conventional open surgery

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Pornthep Kasemsiri ◽  
Srongpaun Trakulkajornsak ◽  
Piyapong Bamroong ◽  
Kanokkarn Mahawerawat ◽  
Patorn Piromchai ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Thyroid Surgery ◽  
Open Surgery ◽  
Endoscopic Thyroid Surgery ◽  
Conventional Open Surgery

scholarly journals Quality of life and surgical outcome of ABBA versus EndoCATS endoscopic thyroid surgery: a single center experience

2021 ◽  
Author(s):  
Ulrich Wirth ◽  
Thomas von Ahnen ◽  
Josef Hampel ◽  
Josefine Schardey ◽  
Peter Busch ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Patient Satisfaction ◽  
Thyroid Surgery ◽  
Surgical Patients ◽  
Single Center ◽  
Perioperative Outcome ◽  
Endoscopic Thyroid Surgery ◽  
Significant Difference ◽  
German Standard

Abstract Background Thyroid surgery is often performed, especially in young female patients. As patient satisfaction become more and more important, different extra-cervical “remote” approaches have evolved to avoid visible scars in the neck for better cosmetic outcome. The most common remote approaches are the transaxillary and retroauricular. Aim of this work is to compare Endoscopic Cephalic Access Thyroid Surgery (EndoCATS) and axillo-bilateral-breast approach (ABBA) to standard open procedures regarding perioperative outcome and in addition to control cohorts regarding quality of life (QoL) and patient satisfaction. Methods In a single center, 59 EndoCATS und 52 ABBA procedures were included out of a 2 years period and compared to 225 open procedures using propensity-score matching. For the endoscopic procedures, cosmetic outcome, patient satisfaction and QoL (SF-12 questionnaire) were examined in prospective follow-up. For QoL a German standard cohort and non-surgically patients with thyroid disease were used as controls. Result The overall perioperative outcome was similar for all endoscopic compared to open thyroid surgeries. Surgical time was longer for endoscopic procedures. There were no cases of permanent hypoparathyroidism and no significant differences regarding temporary or permanent recurrent laryngeal nerve (RLN) palsies between open and ABBA or EndoCATS procedures (χ2; p = 0.893 and 0.840). For ABBA and EndoCATS, 89.6% and 94.2% of patients were satisfied with the surgical procedure. Regarding QoL, there was an overall significant difference in distribution for physical, but not for mental health between groups (p < 0.001 and 0.658). Both endoscopic groups performed slightly worse regarding physical health, but without significant difference between the individual groups in post hoc multiple comparison. Conclusion Endoscopic thyroid surgery is safe with comparable perioperative outcome in experienced high-volume centers. Patient satisfaction and cosmetic results are excellent; QoL is impaired in surgical patients, as they perform slightly worse compared to German standard cohort and non-surgical patients.

Assessing National Utilization Trends and Outcomes of Robotic and Endoscopic Thyroidectomy in the United States

2020 ◽  
Vol 163 (5) ◽  
pp. 947-955 ◽  
Author(s):  
Daniel Jacobs ◽  
Sina J. Torabi ◽  
Courtney Gibson ◽  
Rahmatullah Rahmati ◽  
Saral Mehra ◽  
...  
Keyword(s):  
Thyroid Surgery ◽  
Open Surgery ◽  
Endoscopic Thyroidectomy ◽  
Postoperative Mortality ◽  
The United States ◽  
Complication Rates ◽  
Endoscopic Thyroid Surgery ◽  
Increased Risk ◽  
Robotic Thyroid Surgery ◽  
Over Time

Objective We aimed to evaluate trends and outcomes of surgical approaches to thyroid surgery. We hypothesized that there have been changes over time in the utilization of approaches to thyroidectomy, including endoscopic, robotic, and open approaches, and that patient outcomes may differ between open surgery and endoscopic or robotic approaches. Study Design Retrospective analysis. Setting The National Cancer Database (NCDB) was queried between 2010 and 2016. Subjects and Methods National cohort of patients. Descriptive statistics were performed using χ2 test, Mann-Whitney U test, t test and analysis of variance. To investigate complication rates, patient matching was performed with subsequent analysis using simple and multivariable logistic regressions. Results We identified 217,938 patients within the NCDB. While endoscopic thyroid surgery increased, relatively, in use over time (0.93% to 2.34% of cases in 2010 and 2016, respectively), robotic thyroid surgery started to decline relatively to other approaches from 2013 to 2016 (0.39% to 0.25% of cases, respectively). The endoscopic approach was performed more commonly than the robotic approach within individual facilities that have reported both procedures ( P = .025). Robotic thyroid surgery was associated with increased risk of positive margins ( P = .046), while endoscopic thyroid surgery was associated with a higher rate of unplanned hospital readmission (OR, 1.55; 95% CI, 1.09-2.22), longer inpatient stays (OR, 1.55; 95% CI, 1.19-2.02), and higher 90-day postoperative mortality (OR, 4.45; 95% CI, 1.58-12.6). Conclusion Endoscopic thyroid surgery has increased in utilization since 2004 but may have worse morbidity and mortality outcomes compared to open surgery.

scholarly journals Towards a Low-Cost Mobile Subcutaneous Vein Detection Solution Using Near-Infrared Spectroscopy

2014 ◽  
Vol 2014 ◽  
pp. 1-15 ◽  
Author(s):  
Simon Juric ◽  
Vojko Flis ◽  
Matjaz Debevc ◽  
Andreas Holzinger ◽  
Borut Zalik
Keyword(s):  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Infrared Imaging ◽  
Low Cost ◽  
Grey Literature ◽  
Cost Effective ◽  
Research Direction ◽  
Future Research ◽  
Pubmed Database

Excessive venipunctures are both time- and resource-consuming events, which cause anxiety, pain, and distress in patients, or can lead to severe harmful injuries. We propose a low-cost mobile health solution for subcutaneous vein detection using near-infrared spectroscopy, along with an assessment of the current state of the art in this field. The first objective of this study was to get a deeper overview of the research topic, through the initial team discussions and a detailed literature review (using both academic and grey literature). The second objective, that is, identifying the commercial systems employing near-infrared spectroscopy, was conducted using the PubMed database. The goal of the third objective was to identify and evaluate (using the IEEE Xplore database) the research efforts in the field of low-cost near-infrared imaging in general, as a basis for the conceptual model of the upcoming prototype. Although the reviewed commercial devices have demonstrated usefulness and value for peripheral veins visualization, other evaluated clinical outcomes are less conclusive. Previous studies regarding low-cost near-infrared systems demonstrated the general feasibility of developing cost-effective vein detection systems; however, their limitations are restricting their applicability to clinical practice. Finally, based on the current findings, we outline the future research direction.

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