Endoscopic Thyroidectomy Using a New Bilateral Axillo‐Breast Approach

Choe, Jun Ho; Kim, Seok Won; Chung, Ki-Wook; Park, Kyoung Sik; Han, Wonshik; Noh, Dong‐Young; Oh, Seung Keun; Youn, Yeo-Kyu

doi:10.1007/s00268-006-0481-y

Cited by 354 publications

(271 citation statements)

References 26 publications

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“…12,13 These can be grouped into those that use small cervical incisions, either ventral or lateral, and those that use the distant chest wall and periareolar, axillary, or combined approaches. 5,8,[14][15][16][17][18][19] Our approach was using contralateral breast and axillary approach using same instruments as in conventional laparoscopy. The only scar one gets is at the port site which is in an area not exposed and hidden by undergarments.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Thyroidectomy—Preliminary Experience from a Tertiary Care Center in Delhi, India

Aggarwal¹,

Raja²,

Garg³

et al. 2017

US Endocrinology

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C osmesis after thyroid surgery has always been a concern for patients approaching thyroid surgery. To achieve a scarless surgery in the neck, endoscopic thyroidectomy using different techniques has been described in the literature. The aim of this article is to study the feasibility of endoscopic combined axillary breast approach for thyroid surgery. This is a retrospective study in the department of Endocrine Surgery from a tertiary care center in Delhi, India. Patients who underwent endoscopic thyroidectomy at our center during May 2010-November 2015 were included. The procedure was carried out in subjects who opted for the procedure with unilateral thyroid nodules of size less than 4 cm, with benign and indeterminate cytology, and with no previous neck surgery or radiation to the neck. The details of demographic profile, operative parameters, and postoperative management were collected for all the cases. All 12 subjects were females. The mean age of the subjects was 27.2 (range 14-45) years. Mean operative time was 187 (range 110-232) minutes. There was a temporary recurrent laryngeal nerve injury in one case, local wound infection in two cases, prolonged subcutaneous emphysema in five cases, and prolonged analgesic requirement (>5 days) in 10 cases. No life-threatening complications were seen in any of the subjects. Cosmetic results were excellent as there was no visible scar in the neck. The combined breast axillary approach using endoscopic technique for unilateral thyroid nodule is feasible with acceptable morbidity and can be offered to selected patients for cosmetic advantage. KeywordsEndoscopic thyroidectomy, minimally invasive thyroidectomy, thyroid nodule Disclosure: Vivek Aggarwal, Bhanu Kiran Raja, Monika Garg, Deepak Khandelwal, and Bhoopendra Agarwal have nothing to declare in relation to this article. No funding was received for the publication of this article.Compliance with Ethics: All procedures were followed in accordance with the responsible committee on human experimentation and with the Helsinki Declaration of 1975 and subsequent revisions.Authorship: All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship of this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published.Open Access: This article is published under the Creative Commons Attribution Noncommercial License, which permits any non-commercial use, distribution, adaptation and reproduction provided the original author(s) and source are given appropriate credit. Ever since thyroid surgery has been described, there is ongoing evolution in the surgical techniques of thyroidectomy. The development aims at increasing safety and improving cosmesis.To achieve safety, surgeons have adopted a number of new technologies such as intraoperative neuromonitoring of recurrent laryngeal nerve (RLN), postoperative parathyroid hormone (PTH) assay, and alternative energy devices such as ultrasonic shears or bipolar coa...

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Section: Discussionmentioning

confidence: 99%

Endoscopic Thyroidectomy—Preliminary Experience from a Tertiary Care Center in Delhi, India

Aggarwal¹,

Raja²,

Garg³

et al. 2017

US Endocrinology

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“…Breast and axillary approaches to endoscopic thyroidectomy (ETAA) were both developed by Asian surgeons (19,20). ETBA has an advantage over ETAA in terms of a wide triangular positioning of instruments so they do not interfere with one another (21), and ETBA offers excellent visualization when approaching bilateral lesions. Thus, ETBA is the most popular approach for endoscopic thyroidectomy in China (22).…”

Section: Discussionmentioning

confidence: 99%

“…Thus, ETBA is the most popular approach for endoscopic thyroidectomy in China (22). However, ETBA is inferior in terms of cosmetics as it may leave a hypertrophic parasternal scar (21,23). To resolve this issue, the breast and axillary approaches were combined, including the bilateral axillo-breast approach (BABA) (24), axillo-bilateral breast approach (ABBA) (25) and bilateral breast areola and ipsilateral ETBA with the mini-instrument results in a scar with an almost identical appearance since the 2-mm miniincision was no longer evident during the follow-up 3 months postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Use of a mini-instrument in endoscopic thyroidectomy via a breast approach to improve cosmetic outcomes

Zhang

Dang

Shan

et al. 2014

BST

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“…Later on, Choe et al added a contralateral axillary incision, called the technique bilateral axillo-breast (BABA) approach (14). Due to the wide dissection needed and the post-operative chest discomfort, some authors qualified this technique by "maximally" invasive (15,16).…”

Section: Review Articlementioning

confidence: 99%

Gasless trans-axillary robotic thyroidectomy: the introduction and principle

Aïdan

Bechara

2017

Gland Surg.

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A historic review of the main stages of evolution of the minimally-invasive techniques in thyroid surgery. The endoscopic era is divided into direct and indirect approaches. Examples are the minimally invasive video-assisted thyroidectomy (MIVAT) and the minimally invasive lateral approach. The indirect approach is divided into transaxillary and chest/breast incisions. A brief historic review of the advent of robots to the medical and mainly surgical field. And finally, an introduction to transaxillary robotic thyroidectomy.

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Endoscopic Thyroidectomy Using a New Bilateral Axillo‐Breast Approach

Cited by 354 publications

References 26 publications

Endoscopic Thyroidectomy—Preliminary Experience from a Tertiary Care Center in Delhi, India

Endoscopic Thyroidectomy—Preliminary Experience from a Tertiary Care Center in Delhi, India

Use of a mini-instrument in endoscopic thyroidectomy via a breast approach to improve cosmetic outcomes

Gasless trans-axillary robotic thyroidectomy: the introduction and principle

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