Transaxillary Endoscopic Thyroidectomy: An Alternative to Traditional Open Thyroidectomy

Endoscopic Thyroidectomy: The Development in a Chinese Center

“…Since that time, endoscopic thyroidectomy (ET) has been used throughout the planet via multiple approaches, anterior chest, axillary fossa, breast, retroauricular, and combined. [3][4][5][6][7] Although ET has been favorably reviewed, 8,9 it has not been fully accepted and is still limited to some high volume centers. 10 The use of the endoscope for thyroidectomy is dissimilar to its use in other procedures: (1) unlike, for example, cholecystectomy, ET is a cosmetic, not a minimally invasive procedure 11 ; (2) the suitability of ET for thyroid carcinoma has yet to be determined, an issue given potential transplantation of cancers cells via the ''the chimney effect of CO 2 '' 12 ; and (3) technical difficulties 6,[8][9][10][11] (e.g., identification of thyroid neoplasm under endoscope, working space requirements, and instrumentation) hindered ET's acceptance.…”

Endoscopic Thyroidectomy for Bilateral Thyroid Diseases

“…The indication for an endoscopic surgical intervention was bilateral thyroid disease with a maximum diameter of less than 5 cm estimated by preoperative ultrasonography, including multinodular goiter, recurrent thyroid cyst, and toxic thyroid nodule. Exclusion criteria for this approach included (1) nodules greater than 5 cm in diameter, (2) Graves disease, or (3) nodules with an atypical, highly suggestive for malignancy or malignant cytology. Patients with a history of thyroiditis or previous neck surgery and irradiation or patients with a lesion located in the thyroid dorsal area owing to possible injury to the trachea, esophagus, or recurrent laryngeal nerve (RLN) were also excluded.…”

“…6Y10 It has been well documented that the optical enhancement and improved visualization through video magnification speeded its widespread applications. 3,11 However, ET has proved to be of less benefit with regard to its degree of invasiveness compared with conventional open surgery. 3 Even so, it was still preferred by younger women who need reducing or even eliminating neck scarring.…”

“…3,11 However, ET has proved to be of less benefit with regard to its degree of invasiveness compared with conventional open surgery. 3 Even so, it was still preferred by younger women who need reducing or even eliminating neck scarring. 3 Several reports assess ET used in solitary thyroid nodules, one of the most common indications for thyroidectomy.…”

“…3 Even so, it was still preferred by younger women who need reducing or even eliminating neck scarring. 3 Several reports assess ET used in solitary thyroid nodules, one of the most common indications for thyroidectomy. 12 Other criteria for indications and contraindications are still in the process of investigation and continuous renewal.…”