Endoscopic cephalic access thyroid surgery (EndoCATS) using the retroauricular approach - a single centre...

Area of Science:

• Minimally Invasive Surgery
• Surgical Technology
• Endocrinology

Background:

• Advancements in endoscopic and robotic technologies have driven increased adoption of minimally invasive thyroid surgery.
• Patient demand for improved cosmetic outcomes also contributes to the rise of these techniques.

Purpose of the Study:

• To evaluate the short- and long-term outcomes of endoscopic thyroid surgery using EndoCATS.
• To assess the learning curve associated with the EndoCATS procedure.
• To analyze the impact on patients' Quality of Life (QoL).

Main Methods:

• Study included 150 patients undergoing 152 hemithyroidectomies with EndoCATS between 2010 and 2016.
• Perioperative outcomes, including operation time, complications, and QoL, were assessed.
• Analysis included evaluation of the learning curve, with operation time reduction noted after the 53rd case.

Main Results:

• No acute rebleeding or permanent hypoparathyroidism observed.
• Permanent recurrent laryngeal nerve (RLN) palsy occurred in 1.97% of nerves at risk.
• No pneumothorax, infections, or skin flap ischemia; 94.11% of patients reported good or better general health post-surgery.

Conclusions:

• EndoCATS is a safe and effective single-port access endoscopic thyroid surgery technique.
• Extensive training is necessary due to the procedure's demanding nature.
• Advantages include excellent visualization of critical structures and efficient specimen retrieval.