Endocrine Abstracts

Introduction: Endoscopic techniques are uprising in the cervical field mainly because of the exceptional cosmetic results. These surgeries are frequent in the far east Asia but still rare in Europe. We started these approach on November 2014. This paper is a review of our experience.

Aims: To present a series of trans-axillary endoscopic thyroidectomy.

Material and methods: This is a cohort study of 50 consecutive patients treated by trans-axillary endoscopic thyroidectomy. Patients are selected using the following indications: benign or suspicious nodules until 35 mm, micro papillary cancer, lobes until 65 mm. Interventions are video recorded and time, recurrent laryngeal nerve identification and parathyroid identification are registered. Laryngoscopy is performed at the end of the procedure. Morbidity data are collected during surgery, on the day after, 2 weeks, 2 months and one year after the operation. All the pathological reports are reviewed.

Results: Among the series, 78% were women with an average of 48 year old. All patients had normal thyroid function at the time of the operation and 95% were low-risk anaesthetic candidates (ASA1 or 2). Half complained of goitre. All but 2 were submitted to lobectomy. There was no conversion to open surgery. No dead was registered. There were 5 cases of morbidity: 2 seromas, 2 skin burn and 1 transient recurrent laryngeal nerve palsy. All cases of lobectomy were discharged home on post-operative day 1.

Conclusions: Endoscopic cervical approach is difficult to implement among surgeons without advanced laparoscopic skills.The technique revealed to be safe and reproducible with potential to enlarge indications. The use of neuromonitoring, ICG fluorescence and intra-operative ultrasound are tools already tested by the group with a benefit in safety.