Skip to main content
SpringerLink
Log in

Transorale partielle Parathyreoidektomie

Transoral partial parathyroidectomy

  • Kasuistiken
  • Published:
Der Chirurg Aims and scope Submit manuscript

Zusammenfassung

Die Weiterentwicklung minimal-invasiver chirurgischer Verfahren mit dem Ziel der Minimierung des operativen Traumas und Reduktion der perioperativen Morbidität hat zur „natural orifice transluminal endoscopic surgery“ (NOTES) geführt. Dabei werden natürliche Körperöffnungen als Zugang für die operativen Eingriffe genutzt. Die embryonale Entwicklung von Schilddrüse und Nebenschilddrüsen aus den Schlundtaschen und ihrem Deszensus entlang des Ductus thyreoglossus lässt den Mundboden als machbaren natürlichen Zugang für transorale Nebenschilddrüsen- und Schilddürsenoperationen erscheinen. Nachdem wir in tierexperimentellen Untersuchungen und Leichenexperimenten einen rein transoralen Zugang zur Schilddrüsenloge etablieren und die transorale Operationstechnik optimieren konnten, berichten wir nun über die erste rein transorale Exstirpation eines Nebenschilddrüsenadenoms bei einer 37-jährigen Patientin mit primärem Hyperparathyreoidismus.

Abstract

Improvements in minimally invasive surgical techniques have resulted in the development of natural orifice transluminal endoscopic surgery (NOTES) to minimize operative trauma and perioperative morbidity. Considering the embryologic origin and development of the thyroid and parathyroid glands and their descent during embryogenesis into the final position in the neck, a transoral access to the thyroid region via a sublingual mucosal incision seems to be feasible. After implementation and improvement of a transoral access to the thyroid region in an animal model and human cadavers, we now report the first transoral excision of a parathyroid adenoma in a 37-year-old woman suffering from primary hyperparathyroidism.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5
Abb. 6

Literatur

  1. Karakas E, Steinfeldt T, Gockel A et al (2010) Transoral thyroid and parathyroid surgery. Surg Endosc (published online 12/2008). DOI 10.1007/s00464-009-0757-z

  2. Bergenfelz A, Kanngiesser V, Zielke A et al (2005) Conventional bilateral cervical exploration versus open minimally invasive parathyroidectomy under local anaesthesia for primary hyperparathyroidism. Br J Surg 92(2):190–197

    Article  CAS  PubMed  Google Scholar 

  3. Miccoli P (2002) Minimally invasive surgery for thyroid and parathyroid diseases. Surg Endosc 16:3–6

    Article  CAS  PubMed  Google Scholar 

  4. Lorenz K, Miccoli P, Monchik JM et al (2001) Minimally invasive video-assisted parathyroidectomy: multiinstitutional study. World J Surg 25(6):704–707

    Article  CAS  PubMed  Google Scholar 

  5. Barczyński M, Cichoń S, Konturek A, Cichoń W (2006) Minimally invasive video-assisted parathyroidectomy versus open minimally invasive parathyroidectomy for a solitary parathyroid adenoma: a prospective, randomized, blinded trial. World J Surg 30(5):721–731

    Article  PubMed  Google Scholar 

  6. Sebag F, Palazzo FF, Harding J et al (2006) Endoscopic lateral approach thyroid lobectomy: safe evolution from endoscopic parathyroidectomy. World J Surg 30:802–805

    Article  CAS  PubMed  Google Scholar 

  7. Shimizu K (2001) Minimally invasive thyroid surgery. Best Pract Res Clin Endocrinol Metab 15:123–137

    Article  CAS  PubMed  Google Scholar 

  8. Takami H, Ikeda Y (2003) Total endoscopic thyroidectomy. Asian J Surg 26:82–85

    Article  PubMed  Google Scholar 

  9. Kitano H, Fujimura M, Kinoshita T et al (2002) Endoscopic thyroid resection using cutaneous elevation in lieu of insufflation. Surg Endosc 16:88–91

    Article  CAS  PubMed  Google Scholar 

  10. Ikeda Y, Takami H, Niimi M et al (2002) Endoscopic thyroidectomy and parathyroidectomy by the axillary approach: a preliminary report. Surg Endosc 16:92–95

    Article  CAS  PubMed  Google Scholar 

  11. Witzel K (2007) The axillary access in unilateral thyroid resection. Langenbecks Arch Surg 392:617–621

    Article  PubMed  Google Scholar 

  12. Shimizu K, Shiba E, Tamaki Y et al (2003) Endoscopic thyroid surgery through the axillobilateral breast approach. Surg Laparosc Endosc Percutan Tech 13:196–201

    Article  Google Scholar 

  13. Park YL, Han WK, Bae WG (2003) 100 cases of endoscopic thyroidectomy: breast approach. Surg Laparosc Endosc Percutan Tech 13:20–25

    Article  PubMed  Google Scholar 

  14. Ikeda Y, Takami H, Sasaki Y et al (2003) Clinical benefits in endoscopic thyroidectomy by the axillary approach. J Am Coll Surg 196:189–195

    Article  PubMed  Google Scholar 

  15. Cougard P, Osmak L, Esquis P, Ognois P (2005) Endoscopic thyroidectomy; a preliminary report including 40 patients. Ann Chir 130:81–85

    Article  CAS  PubMed  Google Scholar 

  16. Henry JF, Sebag F, Cherenko M et al (2008) Endoscopic parathyroidectomy: why and when? World J Surg 32(11):2509–2515

    Article  PubMed  Google Scholar 

  17. Duh QY (2003) Minimally invasive endocrine surgery: standard of treatment or hype? Surgery 134:849–857

    Article  PubMed  Google Scholar 

  18. Witzel K, v Rahden BHA, Kaminski C, Stein HJ (2008) Transoral access for endoscopic thyroid resection. Surg Endsoc 22:1871–1875

    Article  CAS  Google Scholar 

  19. Wilhelm T, Harlaar J, Kerver A et al (2010) Transorale endoskopische Thyreoidektomie, Teil 1: Rationale und anatomische Studien. Chirurg 81:50–55

    Article  CAS  PubMed  Google Scholar 

  20. Benhidjeb T, Harlaar J, Kerver A et al (2009) Transorale endoskopische Thyreoidektomie, Teil 2: Operationstechnik. Chirurg 1–5

Download references

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Klinik für Visceral-, Thorax- und Gefäßchirurgie, Universitätsklinikum Gießen-Marburg GmbH, Standort Marburg, Baldingerstraße, 35043, Marburg, Deutschland

    E. Karakas MD & D.K. Bartsch

  2. Klinik für Anästhesie und Intensivtherapie, Universitätsklinikum Gießen-Marburg GmbH, Standort Marburg, Marburg, Deutschland

    T. Steinfeldt & A. Gockel

  3. Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Gießen-Marburg GmbH, Standort Marburg, Marburg, Deutschland

    A. Sesterhenn

Authors
  1. E. Karakas MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. Steinfeldt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Gockel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Sesterhenn
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. D.K. Bartsch
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to E. Karakas MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Karakas, E., Steinfeldt, T., Gockel, A. et al. Transorale partielle Parathyreoidektomie. Chirurg 81, 1020–1025 (2010). https://doi.org/10.1007/s00104-010-1922-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00104-010-1922-6

Schlüsselwörter

Keywords

Search

Navigation