Endoscopic Thyroidectomy—Preliminary Experience from a Tertiary Care Center in Delhi, India

Abstract

C osmesis after thyroid surgery has always been a concern for patients approaching thyroid surgery. To achieve a scarless surgery in the neck, endoscopic thyroidectomy using different techniques has been described in the literature. The aim of this article is to study the feasibility of endoscopic combined axillary breast approach for thyroid surgery. This is a retrospective study in the department of Endocrine Surgery from a tertiary care center in Delhi, India. Patients who underwent endoscopic thyroidectomy at our center during May 2010–November 2015 were included. The procedure was carried out in subjects who opted for the procedure with unilateral thyroid nodules of size less than 4 cm, with benign and indeterminate cytology, and with no previous neck surgery or radiation to the neck. The details of demographic profile, operative parameters, and postoperative management were collected for all the cases. All 12 subjects were females. The mean age of the subjects was 27.2 (range 14–45) years. Mean operative time was 187 (range 110–232) minutes. There was a temporary recurrent laryngeal nerve injury in one case, local wound infection in two cases, prolonged subcutaneous emphysema in five cases, and prolonged analgesic requirement (>5 days) in 10 cases. No life-threatening complications were seen in any of the subjects. Cosmetic results were excellent as there was no visible scar in the neck. The combined breast axillary approach using endoscopic technique for unilateral thyroid nodule is feasible with acceptable morbidity and can be offered to selected patients for cosmetic advantage.