Abstract: Objective To explore the application of “hat brim trocar” in transoral endoscopic thyroidectomy vestibular approach （TOETVA）. Methods A total of 126 cases of TOETVA in our hospital from July 2019 to December 2020 were included in the study, in which 78 cases used self-made trocar （observation group） for creating a working space while 48 cases used the common suspension method （control group）. The time of the working cavity creation, bleeding volume and surgical results were compared. Results All operations were not transferred to open surgery. The self-made trocar group used 3 mmHg carbon dioxide low pressure, 10 mL/min low airflow, and the intraoperative space was all exposed. The auxiliary suspension method uses 6 mmHg, 20 ml/min air flow, and the working cavity creation time was longer than that of the Trocar group compared. There was no statistical differences in blood loss surgical complications, carbon dioxide partial pressure trocar group is better than suspension group. Conclusion The self-made trocar reduced the time of working space construction and operation steps, and reduce carbon dioxide accumulation.

Key words: transoral endoscopic thyroidectomy vestibular approach （toetva）, "hat brim trocar"

摘要： 目的 探讨“帽檐Trocar”在经口腔前庭腔镜下甲状腺手术中的应用。方法 分析我院2019年7月至2020年12月在我院行经口腔前庭腔镜下甲状腺手术126例病例,其中实验组为单纯使用帽檐Trocar建立空间及手术,对照组为使用悬吊方法,通过介绍帽檐Trocar的制作及使用情况,并统计建腔使用时间,出血量及手术效果作对比。结果 78例单纯使用自制帽檐Trocar完成建腔及手术,48例使用悬吊方法,全部手术均无中转开放手术,帽檐Trocar组用3 mmHg二氧化碳低气压、10 mL/min低气流,术中空间显露均良好;辅助悬吊方法使用6 mmHg,20 mL/min气流量,建腔时间两组对比帽檐Trocar组优于悬吊法,出血量两组无统计学差异,手术并发症无统计学差异,二氧化碳分压帽檐Trocar组低于悬吊组。结论 使用帽檐Trocar能减少经口腔前庭腔镜下甲状腺手术建腔时间及操作,减少二氧化碳积蓄。

关键词: 帽檐Trocar, 经口腔前庭, 腔镜甲状腺手术