Endoscopic thyroidectomy: a single institute prospective observational study in India
Keywords:Complications, Endoscopy, Techniques, Thyroidectomy
Background: Endoscopic thyroidectomy (ET) is now an accepted treatment for benign and certain malignant thyroid diseases. It is clearly evident that ET is mainly done to lessen pain and avoid scar in the neck. Any procedure which involves using the endoscope to remove thyroid is often collectively called “endoscopic thyroidectomy.” In this article, we would like to share our institute experience in doing ET.
Methods: We did ET on 85 patients from November 2014 to October 2019 mostly by the three-port technique. Preoperative assessment was done and surgery was done on those who met the inclusion criteria. All the cases were done with the insufflation of carbon dioxide gas. Per operative events were noticed and all the patients were followed up at least for 3 to 6 months postoperatively.
Results: The mean age of the patient is 38 years and the majority are females (92.94%). Out of 85 cases, one case was converted to an open method (1.18%). The average operative time to complete the procedure was 67 minutes. Most of the cases were discharged on 2nd to 3rd postoperative days. Few patients had complications like hematoma/seroma formation, paresthesia over the infraclavicular region, skin thermal injury, vascular injury, and tracheal injury.
Conclusion: ET gives excellent cosmesis and lessens the post-operative pain and thus lesser hospital stay even though the extent of the dissection is more than the conventional method. It has variable complications according to the techniques adopted and the size/volume of the surgically excised thyroid gland.
Dhingra JK, Meyers AD. Minimally Invasive Surgery of the Thyroid Treatment and Management. Medscape. 2015. Last accessed on 29 June 2020.
Wong KP, Lang BHH. Endoscopic Thyroidectomy: A Literature Review and Update. Curr Surg Rep. 2013;1:7-15.
Duncan TD1, Rashid QN, Speights F. Surgical excision of large multinodular goiter using an endoscopic transaxillary approach: a case report. Surg Laparosc Endosc Percutan Tech. 2008;18(5):530-5.
Ruggieri M, Straniero A, Genderini M, D'Armiento M, Fumarola A, Trimboli P, et al. The size criteria in minimally invasive video-assisted thyroidectomy. BMC Surg. 2007;7:2.
Park KN, Cho SH, Lee SW. Nationwide Multicenter Survey for Current Status of Endoscopic Thyroidectomy in Korea. Clin Exp Otorhinolaryngol. 2015;8(2):14954.
Touzopoulos P, Karanikas M, Zarogoulidis P, Mitrakas A, Porpodis K, Katsikogiannis N et al. Current surgical status of thyroid diseases. J Multidiscip Healthc. 2011;4:441-49.
Byeon HK, Holsinger FC, Tufano RP, Chung HJ, Kim WS, Koh YW, et al. Robotic total thyroidectomy with modified radical neck dissection via unilateral retroauricular approach. Ann Surg Oncol. 2014;21(12):3872-5.
Bellantone R, Lombardi CP, Raffaelli M, Boscherini M, Alesina PF, Princi P. Central neck lymph node removal during minimally invasive video-assisted thyroidectomy for thyroid carcinoma: a feasible and safe procedure. Journal of Laparoendoscopic and Advanced Surgical Techniques. 2002;12(3):181-5.
Cooper DS, Doherty GM, Haugen BR. American Thyroid Association Guidelines Taskforce. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2006;16:109-41.
Ikeda Y, Takami H, Sasaki Y, Takayama J, Niimi M, Kan S. Clinical benefits in endoscopic thyroidectomy by the axillary approach. J Am Coll Surg. 2003;196(2):189-95.
Shanker US. Endoscopic thyroidectomy and management of its complications. In: Omer Engin, Management of Thyroid Surgery Complications. 1st edition. Lambert Academic Publishing; 2007;64-70.
Gao W, Liu L, Ye G, Song L. Application of Minimally Invasive Video-assisted Technique in Papillary Thyroid Microcarcinoma. Surg Laparosc Endosc Percutan Tech. 2013;23(5):468-73.
Yi Yang, Xiaodong Gu, Wang X, Xiang J, Chen Z. Endoscopic Thyroidectomy for Differentiated Thyroid Cancer. Scientific World Journal. 2012;2012:456807.
Das AT, Prakash SB, Priyadarshini V. Outcomes of Capsular Dissection Technique with Use of Bipolar Electrocautery in Total Thyroidectomy: A Rural Tertiary Center Experience. J Clin Diagn Res. 2016;10(12):MC01-03.