Scarless endoscopic thyroidectomy: breast approach for better cosmesis

Area of Science:

• Surgical Innovation
• Minimally Invasive Surgery
• Endocrinology

Background:

• Traditional thyroidectomy often leaves visible neck scars.
• Patient demand for cosmetic improvements in surgical outcomes is increasing.
• Endoscopic techniques offer potential for scarless surgery.

Purpose of the Study:

• To develop and evaluate a novel endoscopic thyroidectomy technique via a breast approach.
• To assess the feasibility, safety, and cosmetic results of this scarless thyroid surgery.
• To determine the efficacy of the technique for treating thyroid adenomas.

Main Methods:

• A 15-mm incision was made between the nipples for endoscopic access.
• Subcutaneous and subplatysmal spaces were dissected, and CO2 insufflation (6 mm Hg) created the operative space.
• Endoscopic instruments, including an ultrasonically activated scalpel, were used for thyroid dissection through three breast-placed trocars.

Main Results:

• Five female patients with thyroid adenomas (5-7 cm) underwent successful endoscopic thyroidectomy.
• No conversions to open surgery or intraoperative/postoperative complications were reported.
• All patients achieved excellent cosmetic results with no visible neck scars.

Conclusions:

• Endoscopic thyroidectomy via a breast approach is a feasible and safe procedure.
• The technique provides satisfactory cosmetic results, addressing patient concerns about neck scarring.
• Low-pressure CO2 insufflation facilitates safe endoscopic dissection for thyroid procedures.