Extracervical Approaches to Thyroid Surgery: Evolution and Review

Area of Science:

• Minimally Invasive Surgery
• Endocrine Surgery
• Surgical Technology

Background:

• Technological advancements have spurred diverse endoscopic thyroidectomy techniques over 20 years.
• The primary driver for extracervical approaches is improved cosmetic outcomes by avoiding visible scars.
• Existing extracervical routes include transaxillary, trans-breast, postauricular, and transoral, each with varied evidence.

Purpose of the Study:

• To review the evolution of extracervical endoscopic thyroidectomy procedures.
• To analyze different surgical approaches, their outcomes, benefits, and drawbacks.
• To explore the future role of robotic systems in extracervical thyroid surgery.

Main Methods:

• Literature review of extracervical endoscopic thyroidectomy techniques.
• Analysis of reported data on surgical feasibility, safety, patient satisfaction, and cost-effectiveness.
• Examination of current trends and evidence regarding robotic-assisted thyroid surgery.

Main Results:

• Extracervical endoscopic thyroidectomy has evolved with multiple access routes, each presenting unique advantages and disadvantages.
• Robotic-assisted thyroid surgery shows promise for better outcomes and patient satisfaction but is limited by cost, operative time, and training needs.
• Evidence for the technical feasibility, safety, and cost-effectiveness of various extracervical approaches remains varied.

Conclusions:

• Extracervical endoscopic thyroidectomy represents a significant advancement in thyroid surgery, prioritizing cosmesis.
• Robotic technology is emerging in this field, with ongoing evaluation of its benefits versus limitations.
• Further research is needed to optimize safety, feasibility, and cost-effectiveness of robotic extracervical thyroid surgery.