"Three-propulsion" suspension method for endoscopic thyroid surgery gasless axillary approach

Area of Science:

• Minimally Invasive Surgery
• Endoscopic Procedures
• Surgical Anatomy

Background:

• Gasless endoscopic thyroidectomy via a unilateral axillary approach offers advantages like hidden incisions and reduced neck scarring.
• The procedure involves dissection through the thoracic muscle surface, sternocleidomastoid gap, and near the jugular vein, encountering anatomical variations.
• Establishing an adequate surgical cavity is crucial for successful execution.

Purpose of the Study:

• To introduce and explain the "three-propulsion" suspension cavity construction method.
• To detail the key steps, critical points, and considerations for this technique.
• To facilitate gasless endoscopic thyroidectomy through a unilateral axillary approach.

Main Methods:

• The "three-propulsion" method involves sequential dissection from the axillary incision to the clavicle, then to the sternocleidomastoid gap, and finally to the thyroid.
• Utilizes an intraoperative hanging upward hook to aid in cavity creation.
• Focuses on navigating anatomical variations of neck muscles, blood vessels, and nerves.

Main Results:

• The described method effectively establishes a suitable surgical cavity for gasless endoscopic thyroidectomy.
• The technique allows for clear vision and simple manipulation during the procedure.
• Potential for a shorter learning curve and improved patient outcomes regarding scarring and discomfort.

Conclusions:

• The "three-propulsion" suspension cavity construction method is a viable approach for gasless endoscopic thyroidectomy.
• This technique enhances surgical access and visualization through the unilateral axillary route.
• It offers a promising alternative for thyroid surgery with significant patient aesthetic and comfort advantages.