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Tiroidectomia robótica de acesso remoto
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No passado, a cirurgia da tiróide era associada a uma elevada taxa de mortalidade e complicações pós-operatórias. O desenvolvimento das técnicas cirúrgicas e de assepsia tornaram esta cirurgia segura. Nos dias de hoje, a tiroidectomia é aliada a sistemas cirúrgicos robóticos que permitem aceder à tiróide remotamente, evitando cicatrizes visíveis no pescoço. Pacientes relatam um maior grau de satisfação cosmética e dor pós-operatória reduzida. Esse sistema permite ao cirurgião operar com maior destreza, visibilidade e ergonomia, ultrapassando algumas das dificuldades associadas às abordagens tradicionais e endoscópicas. As abordagens robóticas mostraram ter um maior tempo operatório, mas não comprometem a segurança e eficácia da abordagem tradicional, quando aplicadas num grupo criteriosamente seleccionado de pacientes. Com excepção da hipocalcemia e da neuropraxia do plexo braquial, as complicações pós-operatórias parecem ser semelhantes. Os elevados custos associados a este tipo de intervenção, tempos operatórios mais longos e uma íngreme curva de aprendizagem podem constituir barreiras à sua ubiquação.
In the past, thyroid surgery was associated with a high rate of mortality as well as postoperative complications. Thyroidectomy is now a safe surgery due to the development of surgical and aseptic skills. Nowadays, the use of robotic surgical systems allows the remote access of the thyroid, avoiding visible scars on the neck; also, patients report a higher grade of cosmetic satisfaction and reduced postoperative pain. When operating, this system allows enhanced dexterity, visibility and ergonomics, overcoming some of the difficulties associated with traditional and endoscopic approaches. Robotic approaches have been shown to last longer, without compromising the security and efficiency of the traditional approach, when applied to a meticulously selected group of patients. Apart from hypocalcaemia and brachial plexus neuropraxia, postoperative complications seem to be comparable to the traditional approach. The elevated costs associated with this kind of surgery, longer operative times and a steep learning curve might constitute barriers to its worldwide spread.
In the past, thyroid surgery was associated with a high rate of mortality as well as postoperative complications. Thyroidectomy is now a safe surgery due to the development of surgical and aseptic skills. Nowadays, the use of robotic surgical systems allows the remote access of the thyroid, avoiding visible scars on the neck; also, patients report a higher grade of cosmetic satisfaction and reduced postoperative pain. When operating, this system allows enhanced dexterity, visibility and ergonomics, overcoming some of the difficulties associated with traditional and endoscopic approaches. Robotic approaches have been shown to last longer, without compromising the security and efficiency of the traditional approach, when applied to a meticulously selected group of patients. Apart from hypocalcaemia and brachial plexus neuropraxia, postoperative complications seem to be comparable to the traditional approach. The elevated costs associated with this kind of surgery, longer operative times and a steep learning curve might constitute barriers to its worldwide spread.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2018
Palavras-chave
Tiroidectomia Cirurgia robótica Cirurgia de acesso remoto Abordagem transaxilar Otorrinolaringologia