Endoscopic transaxillary approach to the thyroid gland: our early experience

Area of Science:

• Endocrine Surgery
• Minimally Invasive Procedures
• Surgical Oncology

Background:

• Thyroid nodules are common, often benign, but sometimes require surgery.
• Traditional open thyroidectomy leaves visible neck scars.
• Need for less invasive surgical options with better cosmetic results.

Purpose of the Study:

• Evaluate transaxillary endoscopic thyroid lobectomy and isthmectomy.
• Assess safety, feasibility, and outcomes of this minimally invasive approach.
• Compare cosmetic results and visualization with open surgery.

Main Methods:

• 32 patients underwent transaxillary endoscopic thyroid lobectomy with isthmectomy (August 2003-August 2005).
• Utilized a 3-port technique with 5-mm trocars and endoscopic visualization.
• Employed CO2 insufflation and a harmonic scalpel for dissection.

Main Results:

• Successful completion in all patients, no conversion to open surgery.
• Mean operating time: 138.5 min; mean blood loss: 36.4 ml.
• No permanent recurrent laryngeal nerve injury; two temporary hoarseness cases; one hematoma requiring reoperation.

Conclusions:

• Transaxillary endoscopic thyroidectomy is a safe and feasible alternative for select patients.
• Offers improved cosmetic outcomes and enhanced operative visualization.
• A practicable option for thyroid gland removal with aesthetic benefits.