В этой статье вы узнаете:
Thyroid surgery without scar and scarring in Germany!
An innovative method in thyroid surgery through the mouth and treatment in Germany— transoral endoscopic access: through punctures behind the lower lip, endoscopic instruments and a video camera are guided to the gland.
In thyroid surgery, there is a direct correlation between the amount of surgery and the severity of postoperative complications, so surgeons increasingly prefer the transoral access, which has its own advantages:
- The surgery is performed with ultrasonic scissors, which reduces the risk of bleeding.
- The camera magnifies important anatomical structures (parathyroid glands, nerves, vessels) and helps to avoid damaging them.
- The wound in the mouth is sutured with thin threads, which do not need to be removed, they fall off on their own after a few days.
- There is no need to wear a bandage after surgery.
- On the day of surgery, you can drink water, liquid food through the tube.
- Discharged in two to three days.
- The access allows not only the lobe of the gland to be removed, but also the entire organ.
- After the operation, cosmetic defects in the form of scars and stitches on the neck are excluded.
- Postoperative swelling and bruising subsides quickly.
- There is no pronounced pain after surgery, which eliminates taking painkillers.
Thyroid pathology affects seven million people, and every year the number of patients with this disease is growing by 5%, so new methods of treatment of this health problem are very relevant.
The thyroid gland is located in the front of the neck. This organ has two lobes and an isthmus and produces iodine-containing hormones: triiodothyronine (T3), thyroxine (T4), and calcitonin, which regulates calcium metabolism.
Despite its small size, this gland is very important for health. It regulates the work of internal organs and systems (cardiovascular, digestive, reproductive, nervous, respiratory), supports immunity, controls body temperature and metabolism.
Thyroid function is affected by various factors : age, gender, radiation exposure, head and neck injuries, pregnancy, childbirth, infections, immune status.
Everything changes in the body when there is a failure in its work. Thyroid diseases are accompanied by various unpleasant symptoms: palpitations, weight gain or loss, fever, chills, trembling in the hands, exophthalmos, mood swings, hoarseness of voice.
Classification.
For convenience, 3 groups of this disease are distinguished:
- Related to decreased hormone production (hypothyroidism).
- A condition of elevated hormone levels (thyrotoxicosis, hyperthyroidism).
- Processes with morphologic changes (nodular goiter, hypo- or hyperplasia).
Among the diseases are:
- benign functional;
- inflammatory (thyroiditis);
- Autoimmune (chronic autoimmune Hashimoto’s thyroiditis);
- tumorigenic.
Both single nodules and multiple nodules can occur in the thyroid gland. Sometimes, one of the nodules may dominate in terms of growth, size, and functional characteristics.
Nodes in the gland can be:
- tumor-like with overgrowth (hyperplastic);
- with inflammation inside (inflammatory);
- benign (adenomas);
- malignant — primary carcinomas (papillary, follicular, medullary and anaplastic), lymphomas;
- metastatic from another organ.
Treatment.
The peculiarities of thyroid pathology, associated symptoms, as well as the method of treatment affect the success in the struggle for recovery. The importance of the chosen method should not be underestimated, as it affects not only the well-being, but also the social level of life of the patient.
Treatment can be conservative and surgical.
- Medication is used for gland dysfunction when the body has a deficiency/abundance in hormones:
- in hyperthyroidism prescribe drugs that prevent the accumulation of iodine in the gland and hormone production;
- in diffuse goiter on the background of hypothyroidism prescribe hormonal therapy;
- in the nodal course of the disease on the background of hyperfunction, as well as benign hyperplasia prescribe preparations of radioactive iodine.
Surgical treatment (removal of part or the whole organ) is used if the enlarged gland squeezes the surrounding tissue (e.g., adenoma, some forms of nodular goiter) and if cancer is suspected.
Surgery always carries a high risk of damage to the parathyroid glands, which are located on the back of the thyroid.
The parathyroid glands secrete an important hormone, paratgormone, which determines the level of calcium in the blood. Damage or complete removal of the parathyroid glands during surgery leads to a sharp drop in calcium levels, which causes cramps in muscles, including respiratory and cardiac muscles, which can lead to the patient’s death.
To prevent damage to the parathyroid glands, it is necessary to remember that each person can have a different number of them (from 2 to 8) and different locations (near vessels and nerves, behind the esophagus, in front of the spine).
Types of operations.
The classic access is the Kocher access, where the surgeon makes a 6-10 cm skin incision in the neck. This incision allows maximum exposure of the gland and, in case of cancer, lymphatic dissection. The operation is completed by closing the wound with skin using staples, threads or special glue.
Despite the convenience of the method, it should be noted that it leaves a scar on the skin, which, depending on individual characteristics, may over time, either become less noticeable or remain quite pronounced (keloid). This is, of course, very disturbing for patients, especially women, in whom thyroid diseases are more common.
To minimize or avoid the cosmetic defect, the traditional access has been improved: using special instruments, a mini-access is applied with a small skin incision (1.5-2 cm). After such an operation, the scar remains almost invisible, however, such a small incision seriously limits access to the organ, which prevents the performance of extensive operations.
With endoscopic techniques, it is possible to avoid the neck incision altogether. For this purpose, access from the axilla, sternum or behind the ear is used.
Transoral access surgery should not be done if:
- a node larger than 5 centimeters;
- large volume of the thyroid gland (more than 40 cm3);
- if there’s been previous surgery on the gland.
If a patient is suspected of having cancer, then the possibility of transoral access surgery and its scope are discussed in advance with oncologists.
To date, the world has accumulated extensive experience in the surgical treatment of thyroid diseases, but the leader among them is the following transoral endoscopic approach.
- NAME OF SERVICE ADDITIONALLYPRICE, €
- Transoral surgery Thyroid surgery 3500
