METHOD FOR ENDOSCOPIC REMOVAL OF THYROID GLAND IN THYROID CANCER WITH UNDERLYING MULTINODULAR GOITER Russian patent published in 2025 - IPC A61B17/94 A61B18/04 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to endocrine surgery. Points for accessing a thyroid gland and introducing trocars are determined. Linear incision of 1 cm long is made along the outer edge of the greater pectoral muscle. Veress needle is used to inject carbon dioxide into the subcutaneous fat of the neck. First 10 mm trocar is inserted into the formed space. Second 5 mm trocar is placed in a projection of a greater tubercle of humerus along an anterior axillary line. Third 5 mm trocar is placed 2 cm above the paraareolar region. Fourth 5 mm trocar is placed in the left para-areolar region. First trocar is inserted into the optical system of olympus, into the second and third - manipulators: an ultrasonic harmonic scalpel Harmonic and a vacuum aspirator. Harmonic scalpel is used to separate and separate prethyroid muscles, exposing anterior surface of thyroid gland. Clamp inserted into the second trocar is used to lift the right lobe by the lateral edge of the thyroid gland, to cross the branches of the inferior thyroid artery, to separate the inferior parathyroid gland, to visualize the right recurrent laryngeal nerve. Then the lateral side of the right lobe of the thyroid gland is separated with a harmonic scalpel under the control of a reciprocating laryngeal nerve. After the superior parathyroid gland is separated and the superior thyroid artery is transected, the isthmus is separated from the trachea with a harmonic scalpel. Left lobe is removed, while the optic system is left in first 10 mm trocar. Clamp is inserted into second 5 mm trocar to pull back the lower pole of the left lobe of the thyroid gland. In third 5 mm trocar there is an aspirator for removal of smoke and liquid from the field of view. Harmonic scalpel is inserted into fourth 5 mm trocar, which is installed in the left para-areolar region, and the same algorithm of actions is performed step-by-step as with the right lobe.

EFFECT: method enables endoscopic removal of the thyroid gland in case of thyroid cancer with underlying multinodular goiter, adequate visualization of the thyroid pedicle in the immediate vicinity of the gland, reducing the risk of jugular-carotid vessel injury, obtaining a good aesthetic and cosmetic effect.

1 cl, 3 ex