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Endoscopic thyroidectomy using a new bilateral axillo-breast approach.

Jun-Ho Choe1, Seok Won Kim, Ki-Wook Chung

  • 1Department of Surgery, Seoul National University Hospital, Seoul, Republic of Korea.

World Journal of Surgery
|February 20, 2007
PubMed
Summary

The Bilateral Axillo-Breast Approach (BABA) offers a safe and effective endoscopic method for total thyroidectomy, yielding excellent cosmetic outcomes and minimal complications in selected thyroid cancer patients.

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Area of Science:

  • Minimally Invasive Surgery
  • Endoscopic Surgical Techniques
  • Thyroid Surgery

Background:

  • Endoscopic thyroid surgery utilizes cervical, axillary, and breast approaches.
  • The axillo-bilateral breast approach (ABBA) was modified to create the bilateral axillo-breast approach (BABA).

Purpose of the Study:

  • To evaluate the feasibility and outcomes of the BABA technique for total thyroidectomy.
  • To assess complication rates and cosmetic results of BABA endoscopic thyroid surgery.

Main Methods:

  • The BABA technique involves two 12-mm ports via circumareolar incisions and two 5-mm ports via axillary incisions.
  • Procedures were performed with flexible videoscopy and Harmonic scalpel, ensuring visualization of critical structures.

Main Results:

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  • 110 BABA operations were performed, including 52 total thyroidectomies, with a mean operative time of 165.3 minutes.
  • Low complication rates (4 transient vocal cord palsy, 4 transient hypocalcemia, 1 infection) and excellent cosmetic results were observed.
  • Two conversions to open surgery occurred due to capsular invasion and tracheal injury.

Conclusions:

  • The BABA technique is a feasible endoscopic approach for total thyroidectomy.
  • It demonstrates a low rate of postoperative complications and excellent cosmetic results.
  • BABA endoscopic total thyroidectomy is a valid surgical option for selected thyroid cancer cases.