Learning Curve for Endoscopic Thyroidectomy Using Video-Assisted Neck Surgery: Retrospective Analysis of a Surgeon's...

Area of Science:

• Minimally Invasive Surgery
• Surgical Education
• Endocrine Surgery

Background:

• Endoscopic thyroidectomy provides superior cosmetic results but has a steep learning curve.
• Video-assisted neck surgery (VANS) using a subclavian approach is evaluated for surgical proficiency.
• The study focuses on the initial 100 patients treated by a single surgeon.

Purpose of the Study:

• To assess the learning curve for video-assisted neck surgery (VANS) via a subclavian approach.
• To determine the number of cases required for a surgeon to achieve proficiency.
• To identify factors influencing surgical outcomes in VANS.

Main Methods:

• Retrospective analysis of 100 patients undergoing VANS between 2016 and 2020.
• Inclusion of patients with benign or malignant thyroid disease.
• Comparison of outcomes between the first 30 cases and the subsequent 70 cases.

Main Results:

• No significant differences in operative time or blood loss were observed between early and later cases.
• Tumor size was significantly larger in later non-PTC cases.
• Recurrent laryngeal nerve paralysis (RNP) decreased significantly from 26.7% to 5.7% with increased surgical experience.
• Increased experience correlated with a decrease in RNP, while tumor size was a risk factor for blood loss.

Conclusions:

• Satisfactory surgical proficiency in VANS is achieved after approximately 30 cases.
• Experience significantly reduces the risk of recurrent laryngeal nerve paralysis.
• VANS is a viable endoscopic approach for thyroid surgery with a manageable learning curve.