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Transoral endoscopic neck surgery: feasibility and safety in a porcine model based on the example of thymectomy.

机译：经口内窥镜颈部手术：以胸腺切除为例，在猪模型中的可行性和安全性。

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BACKGROUND: In anatomical studies and cadaver dissections, we developed an endoscopic transoral access to the anterior neck region to reduce surgical access trauma. Through a sublingual trocar and two additional trocars in the vestibule of the oral cavity, the pretracheal and thyroid region was reached with standard laparoscopic instruments. METHODS: We conducted an experimental trial in five pigs under general anesthesia to estimate the safety and feasibility of the method; via this approach, the thymus was partially resected. Perioperative antibiotics were administered but analgesics were not given in the postoperative course. Oral intake and behavior were observed during the following 2 days. After necropsy, examination of the access route took place by means of dissections. The tissue surrounding the working trocar was histologically examined. RESULTS: The pretracheal region could be reached without a problem and the procedure was performed almost "bloodlessly" in an anatomically defined layer. The intervention time decreased successively. Postoperative awakening was uneventful. Regular oral food intake was observed after 2-3 h. Pain reactions were not registered during the entire postoperative phase. After dissection, all relations appeared inconspicuous (no infections, fresh/old hematoma). Two local encapsulated seromas were observed. Histologically, only a mild tissue reaction was noted. CONCLUSION: In this study, the endoscopic transoral approach to minimally invasive neck surgery seemed safe and feasible. Minimally invasive endoscopic procedures in the anterior neck region could be a possible application of this new approach.
机译：背景：在解剖学研究和尸体解剖中，我们开发了一种内窥镜经口进入前颈部区域，以减少手术入路创伤。通过舌下套管针和口腔前庭中的另外两个套管针，使用标准的腹腔镜仪器可达到气管前和甲状腺区域。方法：我们在五只猪的全身麻醉下进行了一项实验性试验，以评估该方法的安全性和可行性。通过这种方法，部分切除了胸腺。围手术期使用抗生素，但术后未给予镇痛药。在接下来的两天内观察到了口服摄入量和行为。尸检后，通过解剖检查通路。组织学检查了套管针周围的组织。结果：气管前区域可以毫无问题地到达，并且该手术在解剖学上定义的层中几乎“无血”地进行。干预时间相继减少。术后清醒无障碍。 2-3小时后观察到规律的口服食物摄入量。整个术后阶段均未出现疼痛反应。解剖后，所有关系均不明显（无感染，新鲜/旧血肿）。观察到两个局部包封的血清肿。组织学上，仅观察到轻度的组织反应。结论：在这项研究中，内镜经口入路进行微创颈部手术似乎是安全可行的。前颈区域的微创内窥镜检查程序可能是这种新方法的一种应用。

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