Robotic Transoral Thyroidectomy: Right Thyroidectomy and Ipsilateral Central Neck Dissection with da Vinci Si Surgical System

Transoral approach for thyroidectomy recently gains a lot of attention among the thyroid surgeons, with the merits of cosmetic outcomes and minimal flap dissection. We've successfully introduced the robotic surgical system to the transoral approach for thyroidectomy. For transoral robotic thyroidectomy, we made 3 incisions in the gingival-buccal sulcus for three intraoral ports. An additional axilla port was inserted for counter-traction and later drain insertion. Herein, our unique procedures of transoral robotic thyroidectomy (TORT) are described in the treatment of a patient with papillary thyroid carcinoma.

Robotic transoral thyroidectomy for papillary thyroid carcinoma

Transoral robotic thyroidectomy (TORT) is well consistent with the primary goal of remote-access thyroid surgery, which is to avoid a visible cervical scar. Additionally, the extent of transoral thyroidectomy dissection is less than that of other remote-access surgical procedures. Owing to these merits of the transoral approach, several institutions around the world are now performing this procedure. Since transoral thyroidectomy is performed in a confined, narrow space, and is characterized by a close distance from the ports to the working space, more benefits can be derived from multiarticulation of robotic instruments. Especially when performing left lobectomy by TORT, the surgeon can use right-handed robotic instruments over the thyroid cartilage with the merits of multiarticulation. In this study, we present our unique procedure of left lobectomy by TORT in detail.

Transoral Robotic Thyroidectomy

Transoral approach for thyroidectomy recently gains a lot of attention among the thyroid surgeons, with definite merits over previously developed remote-access approaches. The approach not only resulted in the ideal cosmetic outcome but less postoperative pain with smaller dissection plane in comparison with other approaches. We have successfully introduced the robotic surgical system and its related techniques to this transoral surgical approach for thyroidectomy, which enables the surgeon to have the three-dimentional operative vision and to use the articulating instruments to enhance th eoptimal surgical outcomes. Herein, our unique procedures of transoral robotic thyroidectomy (TORT) are described, and possible advantages and disadvantages of the operation are discussed.

Comparison of four digital resources-authorized access systems based on URL rewriting technology / 中华医学图书情报杂志

The basic functions and characteristics of AUTU-IFC, Union Remote Access System, Shangyi Easy Share System and VPN358 were described in this paper in order to help the users to select their appropriate remote access systems and meet their requirements to access digital resources at any time and at any place.

Comparison of four digital resources-authorized access systems based on URL rewriting technology / 中华医学图书情报杂志

The basic functions and characteristics of AUTU-IFC, Union Remote Access System, Shangyi Easy Share System and VPN358 were described in this paper in order to help the users to select their appropriate remote access systems and meet their requirements to access digital resources at any time and at any place.

Reoperation of Bentall Procedure Using Remote Access Perfusion (RAP) Catheter: A case report / 대한마취과학회지

Redo cardiac operation is extremely hazardous because of adhesions of underlying structures between the sternum and the heart. Total body perfusion through femoral vessel cannulation in conjunction with endovascular aortic clamping can be achieved using remote access perfusion (RAP) endoclamp catheter prior to opening the sternum. We experienced a patient with Marfan syndrome who underwent redo Bentall operation. A 27-year-old male with Marfan syndrome who had undergone two previous Bentall operations was presented with infective endocarditis and pseudoaneurysm of aorta. Total cardiopulmonary bypass perfusion through RAP catheter before the sternotomy was initiated. Safe insertion and proper positioning of RAP catheter was guided by intraoperative transesophageal echocardiography. The operation was uneventful.

Research on remote access system of digital medical library / 医疗卫生装备

Objective To study and analyze technology of proxy server,VPN and specific remote access system.Methods The application of digital medical library was studied in such four aspects as adaptability,security,accessibility and extensibility.Result Many approaches were put forward to break the limits of IP address and realize remote access to digital resources.Conclusion In order to meet the actual requirements in the remote access of digital medical library,the following rules should be observed: the technical scheme with obvious functional limitations should be avoided;importance should be laid on mutual sharing and remote access between chief library and branch library;the maximum concurrent access should be born;multiple certification methods should be utilized as well as multiple techniques such as information distributing.