Minimal invasive surgery in head and neck: video-assisted technique

The recent advent of endoscopic procedures has compelled plastic surgeons to reconsider the conventional methods by which the excision of different types of head and neck tumors are classically achieved. Endoscopic resection is a safe and minimally invasive approach and spares unnecessary discomfort to the patient. This article describes the authors' method for performing a video-assisted surgery for extirpation of benign tumors as branchiogenic cysts, frontal tumors, frontocygomatic cysts, epidermic nasal cysts, and submandibular and sublingual gland diseases. One hundred eight patients were operated on from August 1999 to September 2007 in the Department of Plastic Surgery at the Argerich Hospital of Buenos Aires, Argentina. In all the cases, 3 basic surgical steps were planned: (1) incision, (2) exposure of the tumor, and (3) resection. An endoscope of 20 cm long with a diameter of 4 mm and a vision angle of 0 degree was used. Special curved and righted dissectors, delicate conventional or endoscopic scissors, clamps, and forceps were also used. Transnasal and transoral approaches such as natural orifice surgery were performed in the treatment of nasal cysts and submandibular and sublingual diseases. This experience highlights the video-assisted surgery, demonstrating excellent illumination and a magnified view of the dissection areas, small or hidden incisions, excellent postoperative comfort, and short hospital stay. With the arrival of new surgical techniques, surgeon experience, and advanced endoscopic instruments, the video-assisted surgery can be a safe method of choice in the treatment of the several diseases of the head and neck areas.