Evaluation of the optimal approach for endoscopic neck dissection using Thiel cadavers

Area of Science:

• Minimally Invasive Surgery
• Head and Neck Oncology
• Surgical Anatomy

Background:

• Endoscopic neck dissection (END) techniques are evolving, particularly in Asia.
• Validation of END approaches with minimal learning curves is crucial for widespread adoption.
• Thiel-embalmed cadavers offer a realistic model for surgical simulation.

Purpose of the Study:

• To evaluate and compare different endoscopic neck dissection approaches.
• To identify the technique with the easiest introduction and shortest learning curve.
• To assess the feasibility of END using Thiel-fixed cadavers.

Main Methods:

• Four distinct endoscopic neck dissection approaches were analyzed.
• Surgeon feedback was collected via questionnaires from five head and neck specialists.
• Dissection extent and lymph node yield were quantitatively assessed for each approach.

Main Results:

• The retroauricular (RA) approach for endoscopic supra-omohyoid-neck dissection (SOHND) received the highest surgeon ratings.
• This RA approach demonstrated satisfactory dissection extent and lymph node retrieval.
• Endoscopic jugular neck dissection (JND) via the subclavian approach was the second-best option, needing technique refinement.

Conclusions:

• Endoscopic SOHND using the retroauricular approach is the preferred method for its practicality.
• Endoscopic JND via the subclavian approach presents potential but requires further innovation.