Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach

Area of Science:

• Endocrine Surgery
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Endoscopic thyroid surgery is increasingly chosen for early, low-risk papillary thyroid carcinoma, balancing therapeutic efficacy with cosmetic outcomes.
• The Gasless Endoscopic Thyroidectomy Trans-axillary Approach (GETTA) is gaining traction due to its ease of cavity creation, ample surgical space, clear visualization, and accessible learning curve.
• Detailed procedural descriptions for GETTA remain limited in existing literature.

Purpose of the Study:

• To provide a comprehensive, step-by-step outline of the Gasless Endoscopic Thyroidectomy Trans-axillary Approach (GETTA).
• To synthesize current literature and clinical experience to detail the GETTA procedure for surgeons.
• To highlight the adaptability of the GETTA technique for diverse thyroid and parathyroid pathologies.

Main Methods:

• A five-stage approach to the GETTA procedure is detailed, integrating existing research and clinical expertise.
• Stage 1: Patient positioning and precise incision planning.
• Stage 2: Creation of surgical working cavities.
• Stage 3: Identification and protection of critical structures (recurrent laryngeal nerve, inferior parathyroid gland) and central neck dissection.
• Stage 4: Management of the superior thyroid pole, including superior laryngeal nerve and superior parathyroid gland identification and preservation.
• Stage 5: Transection of the thyroid isthmus and en bloc resection of the thyroid gland and central lymph nodes.

Main Results:

• The described five-step GETTA technique offers a structured and reproducible method for endoscopic thyroidectomy.
• The procedure facilitates precise dissection and protection of vital neurovascular and glandular structures in the neck.
• The GETTA approach is demonstrated to be versatile, applicable to both benign and malignant thyroid and parathyroid diseases.

Conclusions:

• The five-step Gasless Endoscopic Thyroidectomy Trans-axillary Approach (GETTA) is a learnable and adaptable technique for endoscopic thyroid and parathyroid surgery.
• GETTA provides favorable therapeutic and cosmetic outcomes for patients with early-stage thyroid cancer.
• This detailed procedural outline serves as a valuable resource for surgeons adopting or refining the GETTA technique.