Abstract
Objective: Intrathoracic thyroid goiter is an uncommon condition. Most goiters are found in the superior and anterior mediastinum, which can be removed either through a cervical approach or through a combined cervicotomy and sternotomy approach. Extension of the goiter into the posterior mediastinum is even less common. Transcervival approach to thyroid goiters in the posterior mediastinum can be difficult, necessitating a thoracot-omy, with its associated morbidity. Methods: A 69-year-old patient underwent robotic assisted minimally invasive procedure, with the daVinci surgical robotic system to excise a thyroid goiter that extended into the posterior mediastinum. The blood supply of the mediastinal portion of the goiter originated from the right internal thoracic artery. The thoracic and mediastinal portion of the goiter was approached with robot-assisted minimally invasive surgical techniques. Small incisions were used to gain access to the posterior mediastinum via the right pleural cavity, obviating the need for thoracotomy. Using precise movements of the robotic arm, the mediastinal part of the goiter was dissected off vital structures, from within the posterior mediastinum. Total thyroidec-tomy was then completed using the cervical approach. Results: The patient tolerated the procedure well, with minimal intraoperative blood loss. The patient was discharged home after a short hospital stay. Discussion: Robotic surgical techniques for removal of a substernal goiter and other thyroid masses with mediastinal extension, in combination with cervical incision, are effective. Robotic-assisted techniques can complement video-assisted thoracic surgical techniques and broaden the indications for minimally invasive surgery.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 225-228 |
| Number of pages | 4 |
| Journal | Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery |
| Volume | 4 |
| Issue number | 4 |
| DOIs | |
| State | Published - Jul 2009 |
| Externally published | Yes |
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Keywords
- Minimally invasive surgery
- Robotic-assisted surgery
- Substernal goiter
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Surgery
Cite this
A novel robot-assisted technique for excision of a posterior mediastinal thyroid goiter : A combined cervico-mediastinal approach. / Podgaetz, Eitan; Gharagozloo, Farid -; Najam, Farzad; Sadeghi, Nader; Margolis, Marc; Tempesta, Barbara J.
In: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery, Vol. 4, No. 4, 07.2009, p. 225-228.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A novel robot-assisted technique for excision of a posterior mediastinal thyroid goiter
T2 - A combined cervico-mediastinal approach
AU - Podgaetz, Eitan
AU - Gharagozloo, Farid -
AU - Najam, Farzad
AU - Sadeghi, Nader
AU - Margolis, Marc
AU - Tempesta, Barbara J.
PY - 2009/7
Y1 - 2009/7
N2 - Objective: Intrathoracic thyroid goiter is an uncommon condition. Most goiters are found in the superior and anterior mediastinum, which can be removed either through a cervical approach or through a combined cervicotomy and sternotomy approach. Extension of the goiter into the posterior mediastinum is even less common. Transcervival approach to thyroid goiters in the posterior mediastinum can be difficult, necessitating a thoracot-omy, with its associated morbidity. Methods: A 69-year-old patient underwent robotic assisted minimally invasive procedure, with the daVinci surgical robotic system to excise a thyroid goiter that extended into the posterior mediastinum. The blood supply of the mediastinal portion of the goiter originated from the right internal thoracic artery. The thoracic and mediastinal portion of the goiter was approached with robot-assisted minimally invasive surgical techniques. Small incisions were used to gain access to the posterior mediastinum via the right pleural cavity, obviating the need for thoracotomy. Using precise movements of the robotic arm, the mediastinal part of the goiter was dissected off vital structures, from within the posterior mediastinum. Total thyroidec-tomy was then completed using the cervical approach. Results: The patient tolerated the procedure well, with minimal intraoperative blood loss. The patient was discharged home after a short hospital stay. Discussion: Robotic surgical techniques for removal of a substernal goiter and other thyroid masses with mediastinal extension, in combination with cervical incision, are effective. Robotic-assisted techniques can complement video-assisted thoracic surgical techniques and broaden the indications for minimally invasive surgery.
AB - Objective: Intrathoracic thyroid goiter is an uncommon condition. Most goiters are found in the superior and anterior mediastinum, which can be removed either through a cervical approach or through a combined cervicotomy and sternotomy approach. Extension of the goiter into the posterior mediastinum is even less common. Transcervival approach to thyroid goiters in the posterior mediastinum can be difficult, necessitating a thoracot-omy, with its associated morbidity. Methods: A 69-year-old patient underwent robotic assisted minimally invasive procedure, with the daVinci surgical robotic system to excise a thyroid goiter that extended into the posterior mediastinum. The blood supply of the mediastinal portion of the goiter originated from the right internal thoracic artery. The thoracic and mediastinal portion of the goiter was approached with robot-assisted minimally invasive surgical techniques. Small incisions were used to gain access to the posterior mediastinum via the right pleural cavity, obviating the need for thoracotomy. Using precise movements of the robotic arm, the mediastinal part of the goiter was dissected off vital structures, from within the posterior mediastinum. Total thyroidec-tomy was then completed using the cervical approach. Results: The patient tolerated the procedure well, with minimal intraoperative blood loss. The patient was discharged home after a short hospital stay. Discussion: Robotic surgical techniques for removal of a substernal goiter and other thyroid masses with mediastinal extension, in combination with cervical incision, are effective. Robotic-assisted techniques can complement video-assisted thoracic surgical techniques and broaden the indications for minimally invasive surgery.
KW - Minimally invasive surgery
KW - Robotic-assisted surgery
KW - Substernal goiter
UR - http://www.scopus.com/inward/record.url?scp=70349294424&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=70349294424&partnerID=8YFLogxK
U2 - 10.1097/IMI.0b013e3181a69bf0
DO - 10.1097/IMI.0b013e3181a69bf0
M3 - Article
C2 - 22437125
AN - SCOPUS:70349294424
VL - 4
SP - 225
EP - 228
JO - Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
JF - Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
SN - 1556-9845
IS - 4
ER -