Endoscopic Transaxillary Thyroid Lobectomy: Flexible vs Rigid Laparoscope
Suthep Udomsawaengsup MD*, Patpong Navicharern MD*, Chadin Tharavej MD*, Suppa-ut Pungpapong MD*
Affiliation : * Department of Surgery, Faculty of Medicine, Chulalongkorn University
Background : The use of the endoscopic procedure for thyroid lobectomy in benign solitary thyroid nodule has been
developed rapidly and increasingly refined in recent years. The early results are technically feasible, safe and mainly
provide promising cosmetic results, some show a quicker recovery. The authors wanted to know if this procedure can be
performed via rigid laparoscope which is simple, less expensive and widely available in many surgical centers.
Objectives : The aims of this study were to evaluate operative time, blood loss, complication of flexible compared to 30o rigid
laparoscope in endoscopic transaxillary thyroid lobectomy for solitary thyroid nodule.
Method : From February 2004 to June 2004, 13 cases of benign solitary thyroid nodule underwent the endoscopic
transaxillary thyroid lobectomy. Flexible laparoscope techniques were performed in 9 cases and 30o rigid laparoscope in
the other 4 cases. Port site, number of ports and dissected method were the same in both procedures by the same surgeon.
Operative time, blood loss, post-operative results were measured for evaluation.
Results : From 13 cases, 9 in the flexible laparoscope group and 4 in the rigid laparoscope group. All but one in the flexible
group with torn internal jugular vein were successful. The mean operation time was 165.42 + 35.06 minutes, which was
175.63 + 35.70 minutes for flexible laparoscope group and 145 + 26.45 minutes for rigid laparoscope group. There was
no recurrent laryngeal nerve injury and no subcutaneous emphysema. The patients were satisfied with the cosmetic results.
Conclusion : On the basis of early experience with these 13 patients, the authors believe that endoscopic thyroidectomy
using the rigid laparoscope has proved to be no different in the intra-operative results, so the authors do aimed to show that
with the rigid laparoscope which is available in many surgical centers, less expensive and easy in maintenance will provide
another surgical option for treatment of thyroid nodule, with maximized cosmetic effect.
Keywords : Endoscopic surgery, Endocrine surgery, Thyroidectomy, Thyroid lobectomy, Axillary approach, Rigid laparoscope
