Related Experiment Video
Updated: Sep 20, 2025
Minimal Invasive Resection of Large Retrosternal Thyroid Goiter
Published on: September 20, 2024
Combined thoracoscopic and axillary subcutaneous endoscopic thyroidectomy: a novel approach for cervicomediastinal
Yoshiyuki Saito1,2,3,4, Yoshifumi Ikeda5,6, Hiroshi Takami7
1Department of Surgery, International Goodwill Hospital, 1-28-1 Nishigaoka, Izumi-ku, Yokohama, Kanagawa, 245-0006, Japan. yoshiyuksaito@gmail.com.
Purpose:
After our group described the first remote-access thyroidectomy series in 2000, the procedure has been further developed. Although a thoracoscopic approach with a conventional open cervical incision for thyroid goiters with mediastinal extension has been performed at many institutions, remote-access thyroidectomy for cervicomediastinal goiters has not been established. We have performed combined thoracoscopic and axillary subcutaneous endoscopic thyroidectomies (axillo-thoracic endoscopic thyroidectomies). Here, we describe a novel technique for performing a remote-access thyroidectomy for a cervicomediastinal goiter (CMG).
Patients And Methods:
The patients with CMGs who agreed to an axillo-thoracic endoscopic thyroidectomy at one of two hospitals in Japan underwent a remote-access thyroidectomy.
Results:
We performed the axillo-thoracic endoscopic right or left hemithyroidectomy successfully, but most of the patients did not require the thoracoscopic procedure. None of the patients had complications, and none was converted to an open thyroidectomy.
Conclusions:
Most thyroid goiters with substernal extension can be removed by the axillary approach, but some cases require a thoracoscopic approach. The novel approach described herein (axillo-thoracic endoscopic thyroidectomy) enables the safe excision of a CMG with high patient satisfaction for selected patients.
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