Julia P Sumner, Filipe N C M Espinheira Gomes, James A Flanders
{"title":"微创视频辅助犬甲状旁腺切除术:技术描述及可行性研究。","authors":"Julia P Sumner, Filipe N C M Espinheira Gomes, James A Flanders","doi":"10.1111/vsu.13759","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To describe a minimally invasive approach to the parathyroid gland for the treatment of primary hyperparathyroidism.</p><p><strong>Study design: </strong>Surgical technique description and clinical case report.</p><p><strong>Animals: </strong>Five canine cadavers and 5 client-owned dogs with primary hyperparathyroidism.</p><p><strong>Methods: </strong>A surgical technique for minimally invasive video-assisted parathyroidectomy (MIVAP), described for humans, was adapted for dogs. With the dog in dorsal recumbency, a 15 mm incision was made on the midline, 1 finger width caudal to the cricoid cartilage of the larynx. A 5 mm 30° rigid endoscope was inserted into the peritracheal space with the aid of a blunt suction dissector, and fine elevators. The parathyroid was subsequently removed using electrocautery and blunt and sharp dissection. The technique was refined in 5 cadaver dogs to assess feasibility, and was subsequently performed in 5 clinical cases.</p><p><strong>Results: </strong>A minimally invasive approach to the parathyroid gland was possible and allowed successful removal of a parathyroid mass in 5 dogs without complication. The use of fluid ingress was trialed in 1 cadaver and not found to be helpful. The use of a blunt suction dissector greatly facilitated dissection of the peritracheal space.</p><p><strong>Conclusion: </strong>Minimally invasive video-assisted parathyroidectomy is feasible in dogs and was not associated with complications in 5 clinical cases.</p><p><strong>Clinical significance: </strong>Minimally invasive techniques tend to reduce morbidity and are popular with pet owners. This study demonstrates that a minimally invasive technique may be considered for parathyroidectomy in dogs.</p>","PeriodicalId":123280,"journal":{"name":"Veterinary surgery : VS","volume":" ","pages":"O167-O173"},"PeriodicalIF":0.0000,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Minimally invasive video-assisted parathyroidectomy in dogs: Technique description and feasibility study.\",\"authors\":\"Julia P Sumner, Filipe N C M Espinheira Gomes, James A Flanders\",\"doi\":\"10.1111/vsu.13759\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To describe a minimally invasive approach to the parathyroid gland for the treatment of primary hyperparathyroidism.</p><p><strong>Study design: </strong>Surgical technique description and clinical case report.</p><p><strong>Animals: </strong>Five canine cadavers and 5 client-owned dogs with primary hyperparathyroidism.</p><p><strong>Methods: </strong>A surgical technique for minimally invasive video-assisted parathyroidectomy (MIVAP), described for humans, was adapted for dogs. With the dog in dorsal recumbency, a 15 mm incision was made on the midline, 1 finger width caudal to the cricoid cartilage of the larynx. A 5 mm 30° rigid endoscope was inserted into the peritracheal space with the aid of a blunt suction dissector, and fine elevators. The parathyroid was subsequently removed using electrocautery and blunt and sharp dissection. The technique was refined in 5 cadaver dogs to assess feasibility, and was subsequently performed in 5 clinical cases.</p><p><strong>Results: </strong>A minimally invasive approach to the parathyroid gland was possible and allowed successful removal of a parathyroid mass in 5 dogs without complication. The use of fluid ingress was trialed in 1 cadaver and not found to be helpful. The use of a blunt suction dissector greatly facilitated dissection of the peritracheal space.</p><p><strong>Conclusion: </strong>Minimally invasive video-assisted parathyroidectomy is feasible in dogs and was not associated with complications in 5 clinical cases.</p><p><strong>Clinical significance: </strong>Minimally invasive techniques tend to reduce morbidity and are popular with pet owners. This study demonstrates that a minimally invasive technique may be considered for parathyroidectomy in dogs.</p>\",\"PeriodicalId\":123280,\"journal\":{\"name\":\"Veterinary surgery : VS\",\"volume\":\" \",\"pages\":\"O167-O173\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Veterinary surgery : VS\",\"FirstCategoryId\":\"97\",\"ListUrlMain\":\"https://doi.org/10.1111/vsu.13759\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/2/23 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Veterinary surgery : VS","FirstCategoryId":"97","ListUrlMain":"https://doi.org/10.1111/vsu.13759","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/2/23 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1
摘要
目的:介绍一种治疗原发性甲状旁腺功能亢进的微创手术方法。研究设计:手术技术描述和临床病例报告。动物:5只犬尸体和5只客户拥有的原发性甲状旁腺功能亢进的狗。方法:一种用于人类的微创视频辅助甲状旁腺切除术(MIVAP)手术技术被应用于狗。犬背部平卧,在喉环状软骨尾端1指宽的中线处做一个15 mm的切口。在钝吸力解剖器和精细升降机的帮助下,将5 mm 30°刚性内窥镜插入气管周围空间。甲状旁腺随后用电灼和钝尖剥离术切除。该技术在5只尸体犬身上进行了改进以评估可行性,并随后在5例临床病例中进行了试验。结果:微创甲状旁腺入路是可行的,并成功切除了5只狗的甲状旁腺肿块,无并发症。在1具尸体中试验了液体注入法,但没有发现有帮助。钝吸力解剖器的使用极大地促进了气管周围间隙的解剖。结论:5例微创视频辅助甲状旁腺切除术对犬是可行的,无并发症发生。临床意义:微创技术倾向于降低发病率,受到宠物主人的欢迎。本研究表明,微创技术可以考虑在狗甲状旁腺切除术。
Minimally invasive video-assisted parathyroidectomy in dogs: Technique description and feasibility study.
Objective: To describe a minimally invasive approach to the parathyroid gland for the treatment of primary hyperparathyroidism.
Study design: Surgical technique description and clinical case report.
Animals: Five canine cadavers and 5 client-owned dogs with primary hyperparathyroidism.
Methods: A surgical technique for minimally invasive video-assisted parathyroidectomy (MIVAP), described for humans, was adapted for dogs. With the dog in dorsal recumbency, a 15 mm incision was made on the midline, 1 finger width caudal to the cricoid cartilage of the larynx. A 5 mm 30° rigid endoscope was inserted into the peritracheal space with the aid of a blunt suction dissector, and fine elevators. The parathyroid was subsequently removed using electrocautery and blunt and sharp dissection. The technique was refined in 5 cadaver dogs to assess feasibility, and was subsequently performed in 5 clinical cases.
Results: A minimally invasive approach to the parathyroid gland was possible and allowed successful removal of a parathyroid mass in 5 dogs without complication. The use of fluid ingress was trialed in 1 cadaver and not found to be helpful. The use of a blunt suction dissector greatly facilitated dissection of the peritracheal space.
Conclusion: Minimally invasive video-assisted parathyroidectomy is feasible in dogs and was not associated with complications in 5 clinical cases.
Clinical significance: Minimally invasive techniques tend to reduce morbidity and are popular with pet owners. This study demonstrates that a minimally invasive technique may be considered for parathyroidectomy in dogs.