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Updated: Jun 25, 2026

Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach

Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach

Published on: September 15, 2023

The learning curve for endoscopic thyroidectomy: a single surgeon's experience.

Sheng Liu¹, Ming Qiu, Dao-Zhen Jiang

¹18-F Minimally Invasive Surgical Center, Changzheng Hospital, Fengyang Road 415, Shanghai, 200003, China.

Surgical Endoscopy

|February 28, 2009

Summary

This study analyzed 300 endoscopic thyroidectomy cases to define the learning curve. Proficiency in endoscopic thyroidectomy improves significantly after 150 cases, indicating a substantial learning period.

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Area of Science:

Minimally Invasive Surgery
Surgical Education
Endocrine Surgery

Background:

Endoscopic thyroidectomy is a relatively new surgical technique, with limited clinical experience documented.
Further research is needed to understand and optimize the learning process for endoscopic thyroidectomy.
Investigating the learning curve is crucial for assessing and improving surgical expertise.

Purpose of the Study:

To evaluate the learning curve for endoscopic thyroidectomy performed by a single surgeon.
To identify the number of cases required to achieve proficiency and stability in the procedure.
To analyze changes in operative time and performance scores throughout the learning process.

Main Methods:

Retrospective analysis of 300 consecutive endoscopic thyroidectomy cases over 7 years.

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Patients were divided into 10 chronological groups for comparative analysis.

Statistical methods included Pearson's chi-square test and one-way ANOVA to compare outcomes.

Main Results:

The mean operative time was 98.07 minutes, with a 3.7% conversion rate to open surgery.
No significant differences in demographics or complications were observed across the 10 groups.
Significant improvements in operative time (p < 0.01) and operation score (p < 0.01) were noted as the surgeon gained experience, particularly between groups 2-3 and 5-6.

Conclusions:

The initial 60 cases represent the early learning phase for endoscopic thyroidectomy.
Surgical proficiency and consistency in endoscopic thyroidectomy are achieved after approximately 150 cases.
The learning curve demonstrates a clear progression in surgical skill and efficiency over time.