Technical features of endoscopic transaxillary thyroidectomy

• Glushkov P.S.
• Azimov R.Kh.
• Husanov S.S.
• Karneev N.A.
• Levikin K.E.
• Shemyatovsky K.A.
• Gorsky V.A.

Abstract

Endoscopic thyroid surgery is becoming more and more common. Currently, there are various options for minimally invasive approaches to this organ, among which we have chosen transaxillary endoscopic thyroidectomy (TATE). As we mastered the operation, we encountered various technical difficulties that we want to present in this article.

Aim. Describe a basic technical features and rules of TATE that prevention of possible complications.

Material and methods. From 2018 to 2022 in the Department of Surgery of the SCC # 2 Petrovsky National Research Centre of Surgery 112 TATEs were performed. Groups of patients, technical features of the operation, complications and treatment results were analyzed.

Results. Among the operated patients there were 83.9% women and 16.1% men. The average age of operated women was 51.3±13.5, men – 54.4±14.8 years. Surgical complications included one intraoperative bleeding from the superior thyroid artery and one massive bleeding from the median thyroid vein. At the stage of mastering the technique, microperforations of the trachea occurred in two asthenic patients during the allocation of the thyroid lobe. In one patient, during the formation of a cavity in the subcutaneous tissue, a skin burn occurred with ultrasonic scissors in the clavicle area. All complications were stopped intraoperatively and in the postoperative period without consequences. Six patients developed transient unilateral recurrent laryngeal nerve paresis, which resolved within 4–6 weeks.

Conclusion. TATE is a promising but technically complex operation that requires strict adherence to techniques, some of which are not emphasized in the available literature. The principles described in the article will reduce the number of intraoperative complications and improve the results of surgical treatment of patients with thyroid diseases.

Keywords: endoscopic thyroidectomy; transaxillary thyroidectomy; nodular goiter; thyroid surgery; thyroidectomy technique

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