Single-incision gasless trans-subclavian endoscopic approach thyroidectomy

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Endocrinology

Background:

• Traditional endoscopic thyroidectomy approaches have cosmetic benefits but present technical challenges.
• Patient demand for improved aesthetics drives innovation in thyroid surgery techniques.

Purpose of the Study:

• To develop and evaluate the feasibility of a novel single-incision, gasless trans-subclavian endoscopic thyroidectomy.
• To address the cosmetic limitations of existing multi-incision endoscopic thyroidectomy methods.

Main Methods:

• Retrospective review of 243 patients undergoing single-incision gasless trans-subclavian endoscopic thyroidectomy (January 2021-March 2022).
• Data collected included surgical extent, duration, lymph node dissection, complications, and follow-up outcomes.
• Analysis focused on feasibility, safety, and efficacy of the novel approach.

Main Results:

• The single-incision approach was feasible with no conversions to open surgery.
• Mean operative times were 84.9 min for lobectomy + central neck dissection and 95.0 min for lobectomy.
• Low complication rates: temporary recurrent laryngeal nerve injury (8 patients), minor lymphatic fistula (1 patient).
• One case of lateral neck lymph node recurrence detected at 6-month follow-up.

Conclusions:

• The single-incision gasless trans-subclavian endoscopic thyroidectomy is a feasible, minimally invasive option for selected patients.
• This technique provides a scarless cervical outcome and is relatively easy to learn.
• The approach is suitable for widespread clinical adoption due to its simplicity and effectiveness.