Background: Experimental study to evaluate feasibility of continuous intraoperative neural monitoring (C-IONM) in transoral endoscopic thyroidectomy vestibular approach (TOETVA). Methods: Duroc-Landrace pigs were orally intubated with electromyogram endotracheal tube. Automatic periodic stimulation (APS) electrode was allocated in the operative field through the 5-mm ports. APS was then repose on vagal nerve (VN) with different approaches: (1) median, that is, between sternothyroid and thyroid gland; and (2) lateral, that is, between sternocleidomastoid and sternothyroid. VN was stimulated proximally and distally to the APS location to verify whether the dissection and/or placement determined VN injury. Video presentation is offered. Results: Assembled APS accessory was feasible in large-brained animals. The two basic options for VN approaches were tested. Baseline obtained had amplitude values >1000V, bilaterally. Conclusions: C-IONM was feasible in TOETVA in porcine models, but simplification of electrode design and application is needed.

Feasibility of Continuous Intraoperative Neural Monitoring During Transoral Endoscopic Thyroidectomy Vestibular Approach in a Porcine Model / D. Zhang, S. Li, G. Dionigi, T. Wang, J. Zhang, G. Xue, H. Sun1. - In: JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES. - ISSN 1092-6429. - 29:12(2018), pp. 1592-1597. [10.1089/lap.2018.0054]

Feasibility of Continuous Intraoperative Neural Monitoring During Transoral Endoscopic Thyroidectomy Vestibular Approach in a Porcine Model

G. Dionigi;
2018

Abstract

Background: Experimental study to evaluate feasibility of continuous intraoperative neural monitoring (C-IONM) in transoral endoscopic thyroidectomy vestibular approach (TOETVA). Methods: Duroc-Landrace pigs were orally intubated with electromyogram endotracheal tube. Automatic periodic stimulation (APS) electrode was allocated in the operative field through the 5-mm ports. APS was then repose on vagal nerve (VN) with different approaches: (1) median, that is, between sternothyroid and thyroid gland; and (2) lateral, that is, between sternocleidomastoid and sternothyroid. VN was stimulated proximally and distally to the APS location to verify whether the dissection and/or placement determined VN injury. Video presentation is offered. Results: Assembled APS accessory was feasible in large-brained animals. The two basic options for VN approaches were tested. Baseline obtained had amplitude values >1000V, bilaterally. Conclusions: C-IONM was feasible in TOETVA in porcine models, but simplification of electrode design and application is needed.
continuous monitoring; endoscopic thyroidectomy; recurrent laryngeal nerve; thyroid surgery; transoral thyroidectomy; vagal nerve
Settore MED/18 - Chirurgia Generale
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/882340
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