Endoscopic Thyroidectomy (Scarless Thyroid Surgery)

Endoscopic thyroidectomy is also called Minimally Invasive Video-Assisted Thyroidectomy. It is a new surgical technique which allows the surgeon to perform thyroid surgery through a small skin incision. In endoscopic thyroidectomy, very small incisions are made in the axilla. A video camera helps in providing magnified vision of the structures and comfortable dissection. This technique via the axilla helps even removing large thyroid nodules and even helps perform total thyroidectomy.

The benefit of this procedure is that this is a minimally invasive approach (ie., the surgery is performed through a keyhole incision). Other benefits include safety and precision. That is the video camera inserted through the keyhole incision provides a magnified view of the internal structures. Thus the surgeon can perform the surgery by viewing a magnified view of the internal structures on a computer monitor. This increases safety and the surgeon performs the surgery with precision. The greatest benefit is that the neck remains free of scar as the thyroidectomy is performed endoscopically via incisions made at the axilla. The smallest of scars produced are hidden beneath the inner clothes at the axilla. This is a great cosmetic advantage.

Endoscopic Thyroidectomy via Axilla Endoscopic Thyroidectomy via Axilla

Thyroid abnormalities are common among women. As per American Thyroid Association , approximately 90% of all thyroid nodules are benign. Ultrasound of the neck or if needed FNAC (fine-needle aspiration cytology) is used in patients diagnosed with single or multiple thyroid nodules. If malignancy is suspected as per the ultrasound report or the FNAC, then surgery is the advised solution regardless of the size of the swelling. Thyroidectomy is recommended for nodules larger than 4 cm even if the USG and FNAC suggest benign swelling. Depending on the patient history, physical examination as well as the USG and FNAC findings, the surgeon may decide to offer a hemithyroidectomy or total thyroidectomy in consultation with the patient.

  • Using a keyhole ( laparoscopic surgery techniques), a scope is inserted with instruments at the axilla to remove all or part of your thyroid gland.
  • The operation is carried out with special instruments using a camera to guide the surgeon. The camera allows the surgeron to visualize the internal structures with magnification, precision and clarity on a monitor.
  • After the thyroid gland is detached from the trachea, the specimen is placed in a specimen bag.
  • You will have a small drain in the wound which will be removed after a few days.
  • At the end, thyroid gland, part or whole, is removed through one of the incisions.
  • The incisions are then closed.

Endoscopic thyroidectomy incision made at the axilla

Image Showing Endoscopic Thyroidectomy
Incision made near the axilla

Endoscopic thyroidectomy - Thyroid visualized on the screen

In Endoscopic Thyroidectomy a video camera is inserted via the axilla and visualized on the screen


Endoscopic thyroidectomy - Camera with Light to visualize internal structures

Endoscopic Thyroidectomy - Image Showing Video Camera with Light to visualize internal structures

Endoscopic thyroidectomy - Internal Structures Visualized

Endoscopic Thyroidectomy - Internal Structures visualized through video camera


When thyroidectomy is done through the open method, a transverse incision measuring 12–15 cm in length is made on the neck. A large cut is made across the neck or a full cut is required even to remove a small part of the thyroid, even for one side removal leaving behind an ugly scar in the neck with pain, discomfort and delayed recovery. Women find these scars uncomfortable and cosmetically unacceptable. Thyroid disorders and found common in women. Minimal access approaches to thyroid surgery result in a reduction in size or elimination of the scar of the neck.


Open Thyroidectomy produces scar on neck as opposed to Endoscopic Thyroidectomy Scar on performing open thyroidectomy at the neck
Open Thyroidectomy cuts on the neck.  In Endoscopic Thyroidectomy no cuts on neck. Cuts on the neck while performing open thyroidectomy

Scarless Thyroid Surgery - No Scar on Neck

Endoscopic Thyroidectomy via Axilla Pre and Post picture of a patient on whom Thyroidectomy was performed via Endoscopy.

As the incisions are made at the axilla, the neck remains free of scar.

Minimally invasive - No need for a large cut on the neck

Short Hospital Stay - Recovery Time 2 days



Contact Details

Dr. R. Padmakumar
MBBS, DNB, MNAMS, DipALS, FAIS, FIMSA, FCLS, FRCS (GL)
Senior Consultant Laparoscopic and Metabolic Surgeon &
Director - Verwandeln Institute (Transforming Lives)
(Specialist in Laparoscopy, Hernia, Cancer, Obesity, Diabetes Surgery, Endoscopic Thyroid Surgery, Thoracoscopy, Intragastric Balloon)
Keyhole Clinic, Thammanam Road, Plarivattom, Kochi, Kerala, India
VPS Lakeshore Hospital, Maradu, Kochi, Kerala, India
Chairman - Association of Surgeons of India, Kerala Chapter


Mobile: +919447230370, +919846320370
Email: drrpadmakumar@gmail.com

Websites:
www.drrpadmakumar.com
www.endoscopythyroid.com

Chairman, Association of Surgeons of India - Kerala Chapter
National President - Indian Hernia Society (2016)
GC Member, Association of Surgeons of India (2013 - 2018)
Vice President- Society of Endoscopic and Laparoscopic Surgeons of India
Jt. Secretary - Indian Association of Endocrine Surgeons (2016)
Founder Member, Obesity and Metabolic Surgery Society Of India
Founder Member, Association of Minimal Access Surgeons of India
International Faculty of IASGO on Hernia and Diabetic Surgery
International Faculty of IFSO on Diabetic Surgery
Associate Editor : Diabetes and Obesity International Journal