ročník 11,2003 č.4

Endoscopic thyroidectomy by the axillary approach: pure endoscopic procedure

M.Vraný, M.Man, M.Dufek, T.Verner, B. Manová

Hospital Jablonec nad Nisou,
Czech Republic


Conventional thyroidectomy leaves a scar in a cosmetic unfavourable location. Minimally invasive endoscopic thyroidectomy is a more cosmetic favourable alternative.
Axillary approach leads to a reduction of all scars of the neck.


From February 2002 to August 2003, 23 patients (22 females, 1 male) underwent endoscopic thyroidectomy by axillary approach discribed by Ikeda but in our own modification. The acces was made from axilla under the sternocleidomastoid muscle.


Endoscopic procedures were performed successfully for benign disease of the thyroid gland in all cases (9 one-sided thyroidectomies and 14 total thyroidectomies). There was no conversion to open procedure. The operating time for one-sided was 60 to 180 min., for total 180 - 240 min. One patient developed a transitory palsy of the recurrent laryngeal nerve with recovery during 3 weeks. Another complications were haematomas of the neck, but cosmetic results were satisfactory.


Endoscopic thyroidectomy by the axillary approach has some technical difficulties, but allows patients to obtain very good cosmetic results. We believe that axillary approach will find a role in the treatment of endocrine disease in the neck.