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Extracervical approaches to endoscopic thyroid surgery

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Abstract

There is increasing demand for surgical procedures which avoid visible scars while maintaining optimal functional and ideal cosmetic results, without compromising the safety or effectiveness of the procedure. Endoscopic techniques have been adapted to abdominal and pelvic surgery and increasingly employed over the past three decades. Although hampered by the absence of a natural cavity, endoscopic techniques have been adapted to surgery in the neck for the past 15 years, particularly for the thyroid gland. While earlier attempts at endoscopic thyroid surgery were performed through incisions in or near the midline of the neck, recent techniques have been developed to place the incisions and endoscopic ports extracervically, or at least away from the midline region of the neck, rendering the cosmetic result more acceptable. Most of these approaches are through the axilla, breast, chest wall or a combination of approaches. Visualization of the thyroid and rate of complications with these approaches are equal to those attained with older endoscopic approaches. Careful patient selection is important for endoscopic surgery. Complications unique to the endoscopic approach are mostly related to insufflation of cervical tissues with pressurized CO2.

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Disclosures

Authors Giorgos Papaspyrou, Alfio Ferlito, Carl E. Silver, Jochen A. Werner, Eric Genden, and Andreas M. Sesterhenn have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Otolaryngology, Head and Neck Surgery, Philipp University, Marburg, Germany

    Giorgos Papaspyrou, Jochen A. Werner & Andreas M. Sesterhenn

  2. Department of Surgical Sciences, ENT Clinic, University of Udine, Azienda Ospedaliero-Univeristaria, Piazzale S. Maria della Misericordia, 33100, Udine, Italy

    Alfio Ferlito

  3. Departments of Surgery and Otolaryngology—Head and Neck Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA

    Carl E. Silver

  4. Department of Otolaryngology—Head and Neck Surgery, The Mount Sinai Medical Center, New York, NY, USA

    Eric Genden

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  1. Giorgos Papaspyrou
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Correspondence to Alfio Ferlito.

Additional information

This review was written by members and invitees of the International Head and Neck Scientific Group (www.IHNSG.com).

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Papaspyrou, G., Ferlito, A., Silver, C.E. et al. Extracervical approaches to endoscopic thyroid surgery. Surg Endosc 25, 995–1003 (2011). https://doi.org/10.1007/s00464-010-1341-2

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  • DOI: https://doi.org/10.1007/s00464-010-1341-2

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