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Related Experiment Video

Updated: Jul 30, 2025

Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach
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Synergic evacuation device helps smoke control during endoscopic thyroid surgery.

Ting-Chun Kuo1, Kuen-Yuan Chen2, Chieh-Wen Lai3

  • 1Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan; Department of Traumatology, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: https://twitter.com/tinakuo1204.

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|May 18, 2023
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Summary

A smoke evacuation system significantly improves visualization and efficiency during endoscopic thyroid surgery. This technology enhances the field of view and reduces operative time in confined surgical spaces.

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Area of Science:

  • Minimally Invasive Surgery
  • Surgical Technology
  • Endoscopic Procedures

Background:

  • Surgical smoke poses challenges in confined spaces like transoral endoscopic thyroid surgery.
  • Effective resolution of surgical plumes in these procedures remains an unmet need.

Purpose of the Study:

  • To evaluate the efficacy of a smoke evacuation system in endoscopic thyroid surgery.
  • To assess improvements in the field of view and operating time.

Main Methods:

  • Retrospective review of 327 patients undergoing endoscopic thyroidectomy.
  • Comparison of two groups: with and without a smoke evacuation system.
  • Analysis of endoscopic videos for field of view, scope clearance, and air-pocket creation time.

Main Results:

  • The smoke evacuation system group showed significantly better endoscopic views (25% vs 3.13%, P=.01).
  • Reduced instances of endoscope lens removal for cleaning (3.5 vs 6.0 times, P<.01).
  • Decreased time for clear view post-activation (2.67 vs 5.00 seconds, P<.01) and during air-pocket creation (8.67 vs 12.38 minutes, P<.01).

Conclusions:

  • Smoke evacuation systems enhance the field of view in endoscopic thyroid procedures.
  • These systems optimize operative time and reduce smoke-related hazards.
  • Synergistic use with energy devices improves outcomes in small-space endoscopic surgery.