Endoscopic thyroidectomy using a gasless axillary approach

Abstract

Purpose: We have recently developed an endoscopic thyroidectomy using a gasless axillary approach and report the surgical outcome of the procedure.

Materials and methods: The gasless axillary approach was performed through a 3-cm axillary incision using a retractor instead of carbon dioxide insufflation. We performed a total of 35 thyroidectomies using this technique in patients with benign thyroid nodules.

Results: Thirty-four cases were successfully completed with the gasless axillary approach; one case had to be converted to a conventional technique after intraoperative frozen section revealed papillary carcinoma. The mean operative time and mean hospital stay were 180.6 +/- 54.5 minutes and 7.1 +/- 0.9 days, respectively. The mean tumor size was 2.9 +/- 1.4 cm. There were three minor postoperative complications: one case each of wound seroma, transient voice change, and persistent wound pain. All patients were satisfied with the cosmetic result. The axillary scars were not visible when the ipsilateral arms were in their natural position.

Conclusion: Endoscopic thyroidectomy using a gasless axillary approach is a safe procedure that offers a good cosmetic result and has the merits of minimal invasiveness even in patients with a large thyroid mass. It is a safe and feasible alternative to traditional thyroid surgery, especially in young female patients with a large thyroid mass.