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. 2007 Jul;3(3):91-7.
doi: 10.4103/0972-9941.37191.

Endoscopic thyroidectomy: Our technique

Shailesh P Puntambekar  1 , Reshma J Palep, Anjali M Patil, Neeraj V Rayate, Saurabh N Joshi, Geetanjali A Agarwal, Milind Joshi
Affiliations

Endoscopic thyroidectomy: Our technique

Shailesh P Puntambekar et al. J Minim Access Surg. 2007 Jul.

Abstract

Minimally invasive surgery is widely employed for the treatment of thyroid diseases. Several minimal access approaches to the thyroid gland have been described. The commonly performed surgeries have been endoscopic lobectomies. We have performed endoscopic total thyroidectomy by the anterior chest wall approach. In this study, we have described our technique and evaluated the feasibility and efficacy of this procedure.

Materials and methods: From June 2005 to August 2006, 15 cases of endoscopic thyroidectomy were done at our institute. Five patients were male and 10 were female. Mean age was 45 years. (Range 23 to 71 years). Four patients had multinodular goiter and underwent near-total thyroidectomy; four patients had follicular adenoma and underwent hemithyroidectomy. Out of the seven patients of papillary carcinoma, four were low-risk and so a hemithyroidectomy was performed while three patients in the high risk group underwent total thyroidectomy. A detailed description of the surgical technique is provided.

Results: The mean nodule size was 48 mm (range 20-80 mm) and the mean operating time was 85 min (range 60-120 min). In all cases, the recurrent laryngeal nerve was identified and preserved intact, the superior and inferior parathyroids were also identified in all patients. No patients required conversion to an open cervicotomy. All patients were discharged the day after surgery. All thyroidectomies were completed successfully. No recurrent laryngeal nerve palsies or postoperative tetany occurred. The postoperative course was significantly less painful and all patients were satisfied with the cosmetic results.

Conclusions: It is possible to remove large nodules and perform as well as total thyroidectomies using our endoscopic approach. It is a safe and effective technique in the hands of an appropriately trained surgeon. The patients get a cosmetic benefit without any morbidity.

Keywords: Endoscopy; technique; thyroidectomy.

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Conflict of interest statement

Conflict of Interest None declared.

Figures

Figure 1
Figure 1
Position of ports
Figure 2
Figure 2
Creating a subplatysmal palne
Figure 3
Figure 3
Dissection begins at the inferior pole
Figure 4
Figure 4
Clipping inferior thyroid vessels. The recurrent laryngeal nerve is identified and preserved
Figure 5
Figure 5
Posterior dissection
Figure 6
Figure 6
Clipping superior thyroid vessels
Figure 7
Figure 7
Specimen freed up
See this image and copyright information in PMC

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