Related Experiment Video
Updated: Jul 11, 2026
Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach
Published on: September 15, 2023
[Endoscopic thyroidectomy via median approach with gas insufflation: analysis of the first 100 cases]
P Cougard1, L Osmak-Tizon, L Balestra
1Service de Chirurgie générale et endocrinienne, CHU de Dijon, Hôpital général - Dijon. patrick.cougard@chu-dijon
Objective:
To report the initial experience with videoscopic thyroidectomy using a cervical approach with median placement of the optical trocar and gas insufflation.
Patients And Methods:
Retrospective study of the first 100 consecutive patients.
Results:
Seven isthmectomies, 86 lobectomies, and 7 total thyroidectomies were performed. Parathyroidectomy for hyperparathyroidism was also performed in 3 patients. Mean operative time was 77 minutes. No post-operative subcutaneous emphysema was noted. Conversion to open surgery occurred in 10% of cases but the conversion rate decreased to 2.6% when the harmonic scalpel became available. Post-operative complications included one transient recurrent laryngeal nerve palsy. There were no hematomas and no hypocalcemia. The mean post-operative pain scale was 2.7 (on a visual scale of 1-10). Mean hospital stay was 1.5 days. The cosmetic result was considered excellent.
Conclusions:
Endoscopic total thyroidectomy aided by gas insufflation is technically feasible. The harmonic scalpel aids greatly in dissection and hemostasis. It is a valid option in the surgical management of thyroid disease but careful pre-operative selection of patients is mandatory.
