Minimally Invasive Approaches

Mini-incision procedureSmall, 3cm incision with no flap creation and minimal dissection

Pre-tracheal and paratracheal dissectionVideo assistance

Totally endoscopic approachesSupraclavicular, anterior chest*, axillary*, and breast aproach*

*more invasive

Transoral robotic-assisted thyroidectomy Feasible

Endoscopic thyroidectomies are performed under a gerneral anesthesia.

Axillary approach:30mm skin incision 12mm and 5mm trocars Additional 5mm

Anterior chest approach: 12mm skin incision 3-5cm below the border of ipsilateral clavicle 2 additional 5mm toracrs CO2 4mmhg

Anterior border of sternocleidomastoid muscle is then separated

Expose sternothyroid muscle

Splitting the sternothyroid muscle Lower pole retracted upward-RLN Berry's ligament exposed and incised with 5mm clip Upper pole separated

Superior laryngeal nerve

Upper pole of the thyroid gland is dessected free