"Sun's Seven-Step Technique" for Endoscopic En-Bloc Resection of Thyroid Cancer via the Chest-Breast Approach

The oncological radicality and cosmetic outcomes of endoscopic thyroid cancer surgery via the chest-breast approach have been confirmed by numerous studies. The concept of en-bloc resection has been increasingly applied in radical thyroidectomy, whether in open or endoscopic procedures. However, endoscopic en-bloc resection for thyroid cancer presents significant technical challenges, and detailed methodological descriptions remain scarce. To address this, a systematic endoscopic en-bloc resection protocol, termed the "Sun's Seven-Step Technique", was developed. This technique incorporates optimized surgical plane selection, modified operative sequences, and a specialized lymphatic tracer injection method. Compared with the conventional resection group (lobectomy followed by separate lymph node dissection), the en-bloc resection group showed no significant differences in blood loss, lymph node dissection efficacy, or surgical complications; however, it achieved markedly shorter operative times. "Sun's Seven-Step Technique" demonstrates better compliance with oncological radicality principles, facilitates the identification of accidentally resected inferior parathyroid glands, and utilizes preserved tissue integrity to provide mechanical support for exposing lower-level lymph nodes. It served as a valuable reference surgical protocol.