Gasless, endoscopic trans-axillary thyroid surgery: our series of the first 51 human cases

Abstract

Background The safety of gasless endoscopic trans-axillary thyroid surgery is still undetermined. Methods Clinical findings and postoperative complications of patients who had undergone trans-axillary thyroid surgery due to thyroid cancer and thyroid nodules were retrospectively studied. The sensory change and paralysis results from this technique and patients’ satisfaction with the cosmesis were also studied. Results Fifty-one patients (49 females and 2 males) received operations by gasless, endoscopic trans-axillary approaches with one patient whose operation was converted to open surgery because of internal jugular vein injury. Only two patients developed temporary vocal cord paralysis and no patients developed other severe complications. The alleviation of the discomfort in the anterior neck area and sternocleidomastoid, and the cosmetic effect of gasless endoscopic trans-axillary thyroid surgery were acceptable. No evidence of recurrence was found during the follow-up period. Conclusions Gasless, endoscopic trans-axillary thyroid surgery is a feasible procedure with acceptable safety and better cosmetic results in strictly selected patients.

A novel anatomy-based five-settlement method for endoscopic thyroid lobectomy and ipsilateral central compartment neck dissection via gasless unilateral axillary approach: a preliminary report

“…To compare our technique with previous GUA approach reports based on the endoscopic platform, we have reviewed the literature and summarized it in Table 3. The mean age of patients received ranged from 35 to 42.6 (20,(23)(24)(25)(26)(27)(28). The mean BMI ranging The settlement of RLN.…”

Transoral Endoscopic Thyroidectomy Vestibular Approach Versus Gasless Transaxillary Endoscopic Thyroidectomy for Patients With Unilateral Papillary Thyroid Carcinoma: A Retrospective Study

“…During the last century, the number of detected thyroid carcinomas has increased significantly 6 . While conventional open thyroidectomy is still the standard procedure for thyroid carcinoma patients, endoscopic thyroidectomy is gradually becoming accepted for patients with cosmetic needs 7 . The proportion of endoscopic thyroidectomy will be higher in the future for the reason that PTCs occur in more and more young patients with a female predominance 8 .…”

Completion thyroidectomy and lateral neck dissection revealed adhesions in the lateral neck compartment after gasless transaxillary endoscopic thyroidectomy: a case report

“…These approaches require an additional level of expertise and should therefore be performed by surgeons performing large numbers of thyroid and endoscopic procedures ( 9 ). Transaxillary, bilateral axillo-breast approach (BABA) robotic, transoral, and endoscopic total mammary areola approaches have been reported to achieve endoscopic thyroidectomy in our center ( 4 , 10 , 11 ). We further evaluated the safety and effectiveness of these endoscopic approaches compared with conventional approaches and showed that endoscopic procedures were similar to conventional procedures in safety, efficacy, and tumor recurrence but with better cosmetic results and higher patient satisfaction rates regarding quality of life.…”

“…Notably, almost all patients who underwent gasless endoscopic thyroidectomy in our center complained of paraesthesia and stiffness around the anterior chest area and SCM one week after surgery. However, discomfort was relieved over time, and the results were acceptable ( 4 ).…”

“…The da Vinci system is account for a prolonged surgical duration and a higher economic cost. Thus, gasless transaxillary endoscopic thyroidectomy has also been developed without robotic assistance ( 4 ). The transaxillary procedure is very different from the traditional open procedure.…”