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Updated: Oct 18, 2025

Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach
Published on: September 15, 2023
Step-by-step illustrated guide to central neck dissection
F Chu1, R De Berardinis1, G Pietrobon1
1Department of Otorhinolaryngology and Head and Neck Surgery, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico ('IRCCS'), Milan, Italy.
Background:
The incidence of thyroid carcinoma has been increasing worldwide and surgery is the primary treatment. Central compartment dissection of the neck is a very delicate procedure given the risks of recurrent laryngeal nerve injury and hypoparathyroidism.
Methods:
This paper gives a detailed description of this surgical technique in a patient affected by papillary carcinoma of the thyroid gland, supported by highly representative iconographic materials from a tertiary department.
Results:
A stepwise description is provided, along with high-quality pictures and specific tips and tricks. Although neck dissection is a well-codified procedure, the fine details of this surgical technique are not currently available and are still the prerogative of the expert surgeon.
Conclusion:
The central neck compartment contains several vulnerable structures; damage to these structures would affect patients' lives, possibly permanently. Anatomical knowledge and standardisation are needed for all surgeons, particularly new surgeons (such as residents) who cannot rely simply on experience.
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