Related Experiment Video
Updated: Jun 4, 2025

Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach
Published on: September 15, 2023
The Intraoperative Use of a Drain Line for Gas-Insufflation One-Step Single-Port Transaxillary (GOSTA) Robotic
Dohoe Ku1, Young Woo Chang1, Da Young Yu1
1Department of Surgery Korea University College of Medicine Seoul Republic of Korea.
Objective:
This study aimed to evaluate the intraoperative use of a drain line for smoke suction during robotic thyroidectomy using a gas insufflation one-step single-port transaxillary (GOSTA) approach and its impact on surgical outcomes.
Study Design:
Retrospective cohort study.
Setting:
University tertiary care facility.
Methods:
A comprehensive retrospective analysis was conducted in patients divided into 2 groups: the Drain group, where a drain line was directly inserted into the surgical space during surgery (n = 53), and the Control group (n = 83). The 2 groups were compared in terms of perioperative surgical outcomes, including operative time, number of endoscope cleaning, and the number of patients with endoscopes that did not require cleaning.
Results:
The operative time was significantly shorter in the Drain group than in the Control group (P = .003). The number of endoscope cleaning procedures was considerably lower in the Drain group (P < .001), indicating a decreased need for endoscope cleaning during surgery. Moreover, a higher number of patients with endoscopes that did not require cleaning were observed in the Drain group (P = .001), suggesting a potential benefit in maintaining endoscope clarity.
Conclusion:
These results suggest that using smoke suction with a drain line directly inserted into the surgical space in robotic thyroidectomy using the GOSTA approach may offer advantages such as reduced operative time and improved endoscope clarity.
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