Retro-auricular video-assisted "gasless" thyroidectomy: feasibility study in human cadavers

Area of Science:

• Surgical Innovation
• Minimally Invasive Surgery
• Head and Neck Surgery

Background:

• Growing interest in cosmetic surgical approaches for thyroidectomy.
• Current endoscopic methods include CO(2) insufflation or endoscopic assistance.
• A novel retro-auricular endoscopic approach without gas insufflation is presented.

Purpose of the Study:

• To describe and evaluate a novel retro-auricular endoscopic thyroidectomy technique.
• To assess the feasibility of creating surgical space via a retro-auricular incision.
• To determine the efficacy of this approach in hemithyroidectomy with recurrent laryngeal nerve preservation.

Main Methods:

• Utilized six fresh human cadavers.
• Assessed retro-auricular approach and surgical space creation in four head and neck specimens.
• Performed three hemithyroidectomies using the retro-auricular approach with endoscopic guidance.

Main Results:

• Successfully created retro-auricular flap and subplatysmal plane in all cases.
• Achieved successful hemithyroid gland removal in three procedures (100%) using the endoscopic retro-auricular approach.
• Ensured identification and preservation of the recurrent laryngeal nerve in all procedures (100%).

Conclusions:

• The retro-auricular approach, termed the "Walvekar approach," provides adequate surgical space and excellent endoscopic visualization.
• This gasless technique facilitates ipsilateral hemithyroid gland removal.
• The approach offers potential for bilateral thyroidectomy procedures.