Learning curves in endoscopic thyroidectomy: A literature review of different surgical approaches

Objective

This review analyzes the learning curves of various endoscopic thyroidectomy approaches, aiming to guide surgeons in improving training efficiency, reducing learning time, and enhancing surgical safety and outcomes.

Methods

A literature search in PubMed and Web of Science for studies published from January 2014 to April 2024 on the learning curves of endoscopic thyroidectomy was conducted. Studies involving human subjects with specific case data were included; duplicates, non-English publications, animal studies, reviews, and unrelated thyroid conditions were excluded.

Results

A total of 47 studies were reviewed, covering various endoscopic thyroidectomy techniques. The trans-axillary procedure showed a learning curve peak between 30 and 90 cases (average 45.5 for endoscopic, 34.17 for robotic). The trans-breast/chest approach peaked between 25 and 60 cases (average 34.88). Transoral procedures peaked between 12 and 71 cases (average 37 for endoscopic, 28.63 for robotic). The bilateral axillo-breast approach (BABA) peaked at 30 cases for endoscopic surgeries and 15-51 cases for robotic-assisted surgeries (average 36.44).

Conclusion

This study highlights the learning curve differences among various approaches to endoscopic thyroidectomy, providing valuable insights for improving training and increasing the adoption of these techniques.