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The endoscopic approach to the Neck: A review of the literature, and overview of the various techniques

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Abstract

Background

The endoscopic surgical approach to the neck has reached the head and neck surgeons’ view with a certain delay, compared to other fields of endoscopic procedures. This may be attributed to the tight work space and plenty of vital structures in the operating field. Since study groups described first attempts with endoscopic or video assisted removals of thyroid glands in the late nineties, selective neck dissections on animal models or cadaveric dissections were performed in 2003.

Method

The review consists of a Medline Search regarding the terms of endoscopic, video- assisted neck dissections, excision of neck lesions, thyroidectomy and submandibular resection and minimal access surgery. The three main procedures (selective neck dissection, submandibular resection and thyroidectomy) are described and reviewed in the following test.

Results

Various techniques have been performed successfully and led to good clinical results. The studies described in literature other than for thyroidectomy often do not exceed the level of small series or case-reports.

Conclusion

With a good proof of indication gasless lifting techniques, video assisted endoscopical techniques and subcutaneous approaches with gas filling procedures are feasible in neck surgery. All methods depending on the surgeons’ experience describe no significantly extended operation times, a better and faster wound-healing and an optimized cosmetic outcome, compared to open approaches. Surgeons should always be aware of the limitations of the minimal invasive techniques regarding the complications or modifications during neck dissection/thyroidectomy.

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References

  1. Paige KT, Eaves FF III, Wood RJ (1997) Endoscopically assisted plastic surgical procedures in the pediatric patient. J Craniofac Surg 8(3):164–168

    Article  PubMed  CAS  Google Scholar 

  2. Mulhern M, Kirkpatrick N, Joshi N, Vijh V, Coghlan B, Waterhouse N (2002) Endoscopic removal of periorbital lesions. Orbit 21(4):263–269

    Article  PubMed  CAS  Google Scholar 

  3. Shimizu K (2001) Minimally invasive thyroid surgery. Best Pract Res Clin Endocrinol Metab 15(2):123–137

    Article  PubMed  CAS  Google Scholar 

  4. Gottlieb A, Sprung J, Zheng XM, Gagner M (1997) Massive subcutaneous emphysema and severe hypercarbia in a patient during endoscopic transcervical parathyroidectomy using carbon dioxide insufflation. Anesth Analg 84(5):1154–1156

    PubMed  CAS  Google Scholar 

  5. Gagner M (1996) Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism. Br J Surg 83(6):875

    Article  PubMed  CAS  Google Scholar 

  6. Ikeda Y, Takami H, Sasaki Y, Takayama J, Niimi M, Kan S (2002) Comparative study of thyroidectomies. Endoscopic surgery versus conventional open surgery. Surg Endosc 16(12):1741–1745

    Article  PubMed  CAS  Google Scholar 

  7. Kataoka H, Kitano H, Takeuchi E, Fujimura M (2002) Total video endoscopic thyroidectomy via the anterior chest approach using the cervical region-lifting method. Biomed Pharmacother 56(suppl 1):68s–71s

    PubMed  Google Scholar 

  8. Miccoli P, Berti P, Ambrosini CE (2008) Perspective and lessons learned after a decade of minimally invasive video-assisted thyroidectomy. ORL J Otorhinolaryngol Relat Spec 70(5):282–286

    Article  PubMed  CAS  Google Scholar 

  9. Shimizu K, Akira S, Tanaka S (1998) Video-assisted neck surgery: endoscopic resection of benign thyroid tumor aiming at scarless surgery on the neck. J Surg Oncol 69(3):178–180

    Article  PubMed  CAS  Google Scholar 

  10. Shimizu K, Tanaka S (2003) Asian perspective on endoscopic thyroidectomy—a review of 193 cases. Asian J Surg 26(2):92–100

    Article  PubMed  Google Scholar 

  11. Ruggieri M, Straniero A, Mascaro A, Genderini M, D`Armiento M, Gargiulo P, Fumarola A, Trimboli P (2005) The minimally invasive open video-assisted approach in surgical thyroid diseases. BMC Surg 5:9

    Article  PubMed  Google Scholar 

  12. Lombardi CP, Raffaelli M, Princi P, De CC, Bellantone R (2007) Minimally invasive video-assisted functional lateral neck dissection for metastatic papillary thyroid carcinoma. Am J Surg 193(1):114–118

    Article  PubMed  Google Scholar 

  13. Spinelli C, Donatini G, Berti P, Materazzi G, Costanzo S, Miccoli P (2008) Minimally invasive video-assisted thyroidectomy in pediatric patients. J Pediatr Surg 43(7):1259–1261

    Article  PubMed  Google Scholar 

  14. Cougard P, Goudet P, Bilosi M, Peschaud F (2001) Videoendoscopic approach for parathyroid adenomas: results of a prospective study of 100 patients. Ann Chir 126(4):314–319

    Article  PubMed  CAS  Google Scholar 

  15. Akasu H, Shimizu K, Kitagawa W, Ishii R, Tanaka S (2002) Evaluation of an alternative, subclavicular approach to thyroidectomy. Med Sci Monit 8(11):CS80–CS82

    PubMed  Google Scholar 

  16. Benhidjeb T, Wilhelm T, Harlaar J, Kleinrensink GJ, Schneider TA, Stark M (2009) Natural orifice surgery on thyroid gland: totally transoral video-assisted thyroidectomy (TOVAT): report of first experimental results of a new surgical method. Surg Endosc 23(5):1119–1120

    Article  PubMed  CAS  Google Scholar 

  17. Barlehner E, Benhidjeb T (2008) Cervical scarless endoscopic thyroidectomy: axillo-bilateral-breast approach (ABBA). Surg Endosc 22(1):154–157

    Article  PubMed  Google Scholar 

  18. Carreno OJ, Wilson WR, Nootheti PK (1999) Exploring endoscopic neck surgery in a porcine model. Laryngoscope 109(2 Pt 1):236–240

    Article  PubMed  CAS  Google Scholar 

  19. Rubino F, Pamoukian VN, Zhu JF, Deutsch H, Inabnet WB, Gagner M (2000) Endoscopic endocrine neck surgery with carbon dioxide insufflation: the effect on intracranial pressure in a large animal model. Surgery 128(6):1035–1042

    Article  PubMed  CAS  Google Scholar 

  20. Monfared A, Saenz Y, Terris DJ (2002) Endoscopic resection of the submandibular gland in a porcine model. Laryngoscope 112(6):1089–1093

    Article  PubMed  Google Scholar 

  21. Guyot L, Duroure F, Richard O, Lebeau J, Passagia JG, Raphael B (2005) Submandibular gland endoscopic resection: a cadaveric study. Int J Oral Maxillofac Surg 34(4):407–410

    Article  PubMed  CAS  Google Scholar 

  22. Kessler PA, Bumiller L, Kroczek A, Kessler HP, Birkholz T (2009) Minimally invasive neck surgery. Surgical feasibility and physiological effects of carbon dioxide insufflation in a unilateral subplatysmal approach. Int J Oral Maxillofac Surg 38:766–772

    Article  CAS  Google Scholar 

  23. Chen MK, Su CC, Tsai YL, Chang CC (2006) Minimally invasive endoscopic resection of the submandibular gland: a new approach. Head Neck 28(11):1014–1017

    Article  PubMed  Google Scholar 

  24. Baek CH, Jeong HS (2006) Endoscope-assisted submandibular sialadenectomy: a new minimally invasive approach to the submandibular gland. Am J Otolaryngol 27(5):306–309

    Article  PubMed  Google Scholar 

  25. Hamza Y, Khalil R (2009) Video-assisted submandibular resection: two-step technique. Surg Endosc. doi: 10.1007/s00464-009-0492-5. Epub ahead of print

  26. Ruscito P, Pichi B, Marchesi P, Spriano G (2007) Minimally invasive video-assisted submandibular sialoadenectomy: a preliminary report. J Craniofac Surg 18(5):1142–1147

    Article  PubMed  Google Scholar 

  27. Terris DJ, Haus BM, Gourin CG, Lilagan PE (2005) Endo-robotic resection of the submandibular gland in a cadaver model. Head Neck 27(11):946–951

    Article  PubMed  Google Scholar 

  28. Bellantone R, Lombardi CP, Raffaelli M, Boscherini M, Alesina PF, Princi P (2002) Central neck lymph node removal during minimally invasive video-assisted thyroidectomy for thyroid carcinoma: a feasible and safe procedure. J Laparoendosc Adv Surg Tech A 12(3):181–185

    Article  PubMed  Google Scholar 

  29. Werner JA, Sapundzhiev NR, Teymoortash A, Dunne AA, Behr T, Folz BJ (2004) Endoscopic sentinel lymphadenectomy as a new diagnostic approach in the N0 neck. Eur Arch Otorhinolaryngol 261(9):463–468

    Article  PubMed  Google Scholar 

  30. Dutta S, Slater B, Butler M, Albanese CT (2008) “Stealth surgery”: transaxillary subcutaneous endoscopic excision of benign neck lesions. J Pediatr Surg 43(11):2070–2074

    Article  PubMed  Google Scholar 

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Disclosures

The authors Dr. Adrian Muenscher, Dr. Hannes Kutta, Dr. Carsten Dalchow and Prof. Dr. Rainald Knecht have no conflict of interests or financial ties to disclose.

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Correspondence to Adrian Muenscher.

Additional information

Summary and review of new and already established techniques for minimally invasive surgery of the neck.

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Muenscher, A., Dalchow, C., Kutta, H. et al. The endoscopic approach to the Neck: A review of the literature, and overview of the various techniques. Surg Endosc 25, 1358–1363 (2011). https://doi.org/10.1007/s00464-010-1452-9

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  • DOI: https://doi.org/10.1007/s00464-010-1452-9

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