Retro-auricular video-assisted "gasless" thyroidectomy: feasibility study in human cadavers
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Updated: Jun 13, 2026
Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach
Published on: September 15, 2023
Rohan R Walvekar1, Eric Wallace, Beau Bergeron
1Department of Otolaryngology Head and Neck Surgery, LSU Health Sciences Center, 533 Bolivar St, Suite 566, New Orleans, LA 70112, USA. rwalve@lsuhsc.edu
Background:
In recent years, there has been a surge of interest in developing alternative surgical approaches to the thyroid gland with a focus on cosmesis. Approaches can be either complete endoscopic approaches using CO(2) insufflation or endoscopy-assisted approaches. We describe a novel approach for thyroidectomy via a retro-auricular incision without gas insufflation using endoscopic assistance.
Methods:
Six fresh human cadavers were utilized. Four head and neck specimens were used to assess the retro-auricular approach and the creation of surgical space in the lower neck. Three hemithyroidectomy in two fresh human cadavers procedures were performed via a retro-auricular approach. The end-point of the study was successful removal of the hemithyroid gland with preservation of the recurrent laryngeal nerve.
Results:
In all cases, the retro-auricular flap and subplatysmal plane could be achieved without difficulty. Three hemithyroid specimens were successfully removed in two cadaveric specimens using the retro-auricular approach with endoscopic guidance. Thyroid gland resection with identification and preservation of the recurrent laryngeal nerve could be achieved in all three procedures (100%).
Conclusion:
The retro-auricular approach or the "Walvekar approach" permits adequate working space and an excellent endoscopic surgical view for removal of the ipsilateral hemithyroid gland with an option for a bilateral approach using a "gasless technique."
