Total Endoscopic Thyroidectomy: Axillary Approach
Minimally invasive surgery has recently been applied to thyroid and parathyroid disease, and the resulting scars on the neck are small and inconspicuous. However, there are some patients that feel uneasy about even having a small scar on their neck. Total endoscopic thyroidectomy by the axillary approach, first performed in 1999, is a remote access technique that eliminates the need for a cervical incision. This procedure enables the surgeon to complete a thyroidectomy with a minimal amount of surgical dissection, because the entire thyroid lobe can be identified from a lateral view without dissecting the sternohyoid muscle. Additionally, the operation can be performed at a low CO2 insufflation pressure, thereby minimizing the risk of insufflation-related complications. In this chapter, we describe the indications and operative details of this surgical procedure.