April 11, 2017
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SCARLESS THYROID SURGERY (THYROID SURGERY WITHOUT SCAR)
DR LAM RUEY SHYANG 蓝瑞祥医生
Conventional open thyroidectomy remains the treatment of choice for benign and malignant thyroid nodules, but the surgery requires a long incision line on the neck and leaves a long scar on the lower anterior neck. This incision may lead to prominent scarring that can develop into keloid or hypertrophic scars and lead to paraesthesia or hypaesthesia.
With the development of laparoscopic and endoscopic surgery, thyroid and parathyroid surgery has recently been attempted using an endoscopic approach. Since endoscopic parathyroidectomy and thyroidectomy were first introduced by Gagner and Huscher et al., various endoscopic thyroid surgery approaches have been devised, including cervical, axillary, breast, and anterior chest approaches.
Endoscopic thyroidectomy (scarless thyroid surgery / thyroid surgery without scar) was initially performed in patients with benign thyroid nodules. As surgical experience was accumulated, the application of endoscopic thyroidectomy was extended to patients with early cases of thyroid cancer.
Endoscopic Thyroidectomy (Scarless Thyroid Surgery)
Our endoscopic technique using the unilateral axillo-breast approach helps to remove large nodules of the thyroid as well as performing total thyroidectomies. It combines the benefits of the minimal access approach, instrumentation, magnification and precision. The scars produced are hidden beneath the smallest of clothes offering a great cosmetic advantage.
But only about 20% of total thyroid surgeries are suitable for this type of surgery.
Size of thyroid swelling is less than 4cm
Total thyroid volume is less than 30cc
Early stage of thyroid cancer, Stage 1 and 2 papillary thyroid cancer
Follicular thyroid lesions
Prophylactic total thyroidectomy in case of hereditary thyroid cancer (eg, medullary thyroid cancer)
Stage 3 or 4 of thyroid cancer
Large multinodular goiter
History of neck radiation, eg radiotherapy on neck for other malignancies