METHOD OF PROTECTING RECURRENT LARGENOUS NERVE DURING ENDOSCOPIC OPERATIONS ON THYROID GLAND Russian patent published in 2023 - IPC A61B17/94 A61B17/32 A61B18/04 

FIELD: medicine; surgery and oncology.

SUBSTANCE: infiltration of the mucous membrane and submucosal layer in the lower fornix of the vestibule of the oral cavity is performed. Subcutaneous fat is infiltrated in the chin area and submental triangle with the following solution: 1 mg of adrenaline per 500 ml of saline. Incisions are made in the mucous membrane of the vestibule of the oral cavity at the level of 1.1 of the lower incisors, 1 cm long, in the mucous membrane of the vestibule of the oral cavity at the level of the lower canines up to 0.5 cm. A Veress needle is inserted into the incision of the vestibule of the oral cavity at the level of 1.1 of the lower incisors. Subcutaneous access to CO₂ under pressure is provided. A 10-mm trocar and two 5-mm trocars are installed into the incisions made in the mucous membrane of the vestibule of the oral cavity at the level of 1.1 of the lower incisors, 1 cm long, and in the mucous membrane of the vestibule of the oral cavity at the level of the lower canines up to 0.5 cm. Using video endoscopic visualization, the thyroid gland is accessed with a harmonic scalpel. The neck muscles are separated and the thyroid gland is exposed. Nodular formations are inspected. Coagulation and intersection of the vessels of the upper and lower poles on the right are performed. The recurrent laryngeal nerve is visualized. Intraoperative neuromonitoring (IONM) and intubation with a laryngeal electrode are performed. A tunnel is formed around the recurrent laryngeal nerve (RLN). A latex protector in the form of a tape 1 cm wide and 5 cm long is installed into the formed tunnel. The Berry ligament is crossed at the point where the RLN enters the larynx. Next, the fatty tissue is dissected. Intraoperative neuromonitoring is performed. After the thyroid gland is removed, the latex protector is removed.

EFFECT: method makes it possible to protect the recurrent laryngeal nerve during endoscopic operations on the thyroid gland using vestibular access.

1 cl, 5 dwg, 1 ex