Minimally Invasive Thyroidectomy made more speed & safety

Jang Ho-jin, Professor, Department of Thyroid Endocrine Surgery, Gangnam Severance Hospital

Professor Jang Ho-jin

Thyroid cancer surgery is usually performed by inserting an incision of about 6cm in the center of the front of the neck, and it is true that the neck scar after surgery was burdensome.

 

For this reason, a method of concealing the wound through a robot or endoscope was developed, but this also penetrated the tunnel to access the thyroid gland located in the center of the neck, so there were many difficulties in choosing a surgical method due to disadvantages such as poor skin sensation and extensive adhesion after surgery.

 

In this situation, minimally invasive thyroidectomy (Minimally Invasive Thyroidectomy), which operates by inserting a small incision of about 3 cm on the side rather than the center of the neck, has recently been developed and is attracting attention.

 

Minimally Invasive Thyroidectomy is a method that maintains the advantages of the existing traditional incision method and supplements the disadvantages, drawing attention from many thyroid cancer patients.

 

Currently, Professor Jang Ho-jin of Gangnam Severance Hospital is performing the most, and Minimally Invasive Thyroidectomy accounts for more than 95% of the 1,000 surgeries he performs annually.

 

The Dailypharm met him.

 

-How was Minimally Invasive Thyroidectomy developed? In any case, if the incision was made in the center of the neck, the scar would remain for a long time, and especially for those with hypertrophic scars or keloids, the scars would become thick and unsightly.

 

This is a method developed by his teacher, Professor Park Jeong-soo, to prevent this.

 

At the time, it was a minimal incision method in which only the incision was made small and the neck muscles were cut to access the thyroid gland.

 

As a result, other disadvantages such as adhesion to the wound site and muscle atrophy occurred.

 

Therefore, Minimally Invasive Thyroidectomy is a method that has been supplemented and developed by approaching between the neck muscles (strap muscles, SCM muscles) without cutting the neck muscles without using the minimal incision method.

 

-If the incision is made on one side only, the thyroid gland is a symmetrical butterfly-shaped organ.

 

Is it impossible to remove the entire thyroid gland on the opposite side? No, even if the incision is made on one side, a total resection is also possible to remove the thyroid gland on the opposite side.

 

In addition, even in the case of lateral neck lymph node metastasis, a minimally invasive method other than the traditional incision method is also possible.

 

In general, traditional incisional lymph node surgery inserts a long incision of about 10 cm, whereas minimally invasive incision is limited to the side neck area and only about 5 to 6 cm incision is made.

 

-I think it's definitely more eye-catching than the traditional incision method.

 

Then, what is the difference between surgery time and recovery period after surgery?

 

If the surgical method is more difficult, the operation time and hospitalization period are likely to be longer. Not really.

 

In the case of a half-resection (one side of the thyroid gland), the operation time is about 30 minutes.

 

In the case of hemisection, the discharge tube is usually not required, so the patient is discharged the next day.

 

-Are you saying that recovery after surgery is fast? As the name of the surgical method suggests, it reduces the impact of normal tissues other than the thyroid by reducing the invasion range of not only the skin but also the subcutaneous fat and muscle layer.

 

Recovery is quick because it makes the impact range that our body receives from the outside small.

 

-Are there any side effects or complications of this operation? The three major complications of thyroid cancer surgery are postoperative hemorrhage, voice change due to vocal cord nerve paralysis, hypocalcemia (numbness in the hands and feet) due to parathyroid function decline, and damage to the airway and esophagus.

 

The probability of such a complication is around 1%, and it can be seen that minimally invasive thyroidectomy is similar.