Abstract
Background
Minimal access approaches are increasingly used in endocrine surgery. Several minimal access approaches to the thyroid gland have been described, including a small-incision lateral approach and a video-assisted central approach, but to date no technique has been universally accepted.
Methods
Benefiting from the experience of more than 500 endoscopic parathyroidectomies via a lateral neck approach, the authors developed an endoscopic thyroidectomy based on the same approach and principles. Patients with solitary nodules smaller than 3 cm in diameter and no history of neck surgery or irradiation were offered this operation. A detailed description of the surgical technique is provided.
Results
Of the 742 thyroidectomies performed in 2004, 38 (5.1%) were endoscopic thyroidectomies. The mean nodule size was 22-mm (range, 7–47-mm), and the mean operating time was 99 min (range, 64–150-min). In all cases, the recurrent laryngeal nerve was preserved intact, and the superior and inferior parathyroids were identified, respectively, in 36 and 33 of the 38 patients. Two patients required conversion to an open cervicotomy. All patients were discharged the day after surgery.
Conclusions
The described endoscopic lateral approach combines the coherence of the minimal access lateral approach and the benefits of fiberoptic magnification. It is a safe and effective technique in the hands of an appropriately trained surgeon.
Similar content being viewed by others
References
Assalia A, Gagner M (2004) Laparoscopic adrenalectomy. Br J Surg 91: 1259–1274
Duh QY (2003) Presidential address: minimal access endocrine surgery: standard of treatment or hype? Surgery 134: 849–857
Henry JF (1999) Endoscopic exploration. In: Van Heerden JA, Farley DR (eds.) Surgical exploration for hyperparathyroidism. In operative techniques in general surgery. WB Saunders, Philadelphia pp 49–61
Henry JF, Sebag F, Tamagnini P, Forman C, Silaghi H (2004) Endoscopic parathyroid surgery: results of 365 consecutive procedures. World J Surg 28: 1219–1223
Miccoli P, Berti P, Raffaelli M, Conte M, Materazzi G, Galleri D (2001) Minimally invasive video-assisted thyroidectomy. Am J Surg 181: 567–570
Miccoli P, Elisei R, Materazzi G, Capezzone M, Galleri D, Pacini F, Berti P, Pinchera A (2002) Minimally invasive video-assisted thyroidectomy for papillary carcinoma: a prospective study of its completeness. Surgery 132: 1070–1073
Palazzo FF, Delbridge LW (2004) Minimal access/minimally invasive parathyroidectomy for primary hyperparathyroidism. Surg Clin North Am 84: 717–734
Palazzo FF, Sywak MS, Sidhu SB, Delbridge LW (2005) Safety and feasibility of thyroid lobectomy via a lateral 2.5 cm incision with a cohort comparison of the first 50 cases: evolution of a surgical approach. Langenbecks Arch Surg 390: 230–235
Yeung GH (2002) Endoscopic thyroid surgery today: a diversity of surgical strategies. Thyroid 12: 703–706
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Palazzo, F.F., Sebag, F. & Henry, J.F. Endocrine surgical technique: endoscopic thyroidectomy via the lateral approach. Surg Endosc 20, 339–342 (2006). https://doi.org/10.1007/s00464-005-0385-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-005-0385-1