Endoscopic Thyroidectomy: Experience of Breast and Axillary Approach

Background: The use of endoscopic thyroid surgical procedures leads to avoid the surgical scar in the neck. In this paper we evaluate the merits and limits of endoscopic thyroid surgery through breast and axillary approach. Methods: Between Aug 2013 and Nov. 2014, 437 thyroid surgeries were performed. 27 of them were operated endoscopically through axillary and breast approaches were reviewed prospectively. Three ports were used in this technique, two in axilla and one in ipsilateral areola. Carbon dioxide insufflation up to 6-8mm Hg was used. Results: Endoscopic procedures performed in 27 patients (22 hemi thyroidectomy and 3 total thyroidectomy and one completion thyroidectomy). The mean operating time for hemi thyroidectomy and total thyroidectomy was 148 and 270 minutes respectively. No evidence of recurrent laryngeal nerve injury was observed in any case however there was temporary hypocalcaemia in all four patients operated as total thyroidectomy. The postoperative cosmetic status of the patients was excellent. Conclusions: We believe that endoscopic thyroidectomy by axillary & breast approach will find a role in the treatment of nodular thyroid disease with excellent cosmetic outcome.