METHOD OF ENDOVIDEOSURGICAL ACCESS TO THYROID LOBE Russian patent published in 2019 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to endoscopic endocrine surgery, thyroid surgery and can be used for endovideosurgical access to the thyroid lobe. Three points for introduction of trocars are determined. One point is located in projection of crest of greater tubercle of humerus. Second point is along the upper medial edge of the periareolary area on the ipsilateral breast. Third point is located along the external edge of the greater pectoral muscle at the intersection with the bisector of the surgical action angle formed by the lines connecting the first and second points to the projection point of the involved thyroid gland, respectively. Primary cavity above the clavicle and behind the lateral edge of the pectoral-clavicular-mastoid muscle is created from the third point using an endoscope to connect all trocars. That is followed by dissection, enlarging the primary cavity, and creating an operating cavity for visualizing a portion of the thyroid. Initially, prior to the introduction of the trocar, a Veress needle is inserted into the third point under the subcutaneous fascia in the direction of the thyroid lobe through which carbon dioxide is injected. Carbon dioxide is injected at 16–20 mm Hg. Primary cavity is created by a tube of an endoscope introduced into the trocar, with simultaneous palpation of the pectoris-clavicle-mastoid muscle and insufflation of carbon dioxide. Prior to introduction of tools into trocars from two points, probe-palpator is used.

EFFECT: method enables performing endovideosurgical access to the thyroid lobe and improving the surgical outcome of the patients suffering a thyroid pathology, improving the safety of the surgical intervention by the technique of determining the points and introducing three trocars to improve visualization of the operating cavity, and eliminating the conflict of the instruments.

1 cl, 8 dwg, 1 ex