The goal of minimally invasive surgery is to use newer surgical techniques to minimize the size or visibility of surgical incisions and reduce trauma to patients, thereby shortening their recovery time.

Currently, there are two types of minimally invasive thyroidectomy procedures:

1. Bilateral axillo-breast approach thyroidectomy: This approach involves making incisions in the armpit and around the areola. The surgery is guided by endoscopic visualization, and minimally invasive instruments are used for the thyroidectomy.
2. Transoral thyroidectomy: This approach involves making incisions within the oral cavity. Similarly, endoscopic visualization and minimally invasive instruments are utilized for the thyroidectomy.

Minimally invasive thyroidectomy is currently suitable for patients with smaller thyroid nodules. However, for patients with more severe goiters or larger thyroid nodules, conventional thyroidectomy surgery is more appropriate.

The Bilateral Axillo-Breast Approach Thyroidectomy is a surgical technique for removing the thyroid gland through incisions made in both the areola and the armpit. The advantage of this approach is that the incisions are concealed within the areola and the armpit, avoiding visible scars on the neck. Currently, this method is suitable for treating smaller thyroid nodules.

After the patient is placed under general anesthesia, the surgeon will make 3 to 4 small incisions, approximately 5 to 10 millimeters in size, in both the areola and armpit (as illustrated below). Then, an endoscope is inserted through the incisions until it reaches the neck where the thyroid is located. The endoscope displays images of the surgical area on a monitor, allowing the surgeon to assess the condition within the surgical field. Using minimally invasive instruments, the surgeon will ligate the thyroid’s blood vessels and separate the thyroid from surrounding vital structures. Finally, the excised thyroid gland is removed through the small incisions.

The Trans-Oral Thyroidectomy is a surgical technique for thyroid removal where the incision is made inside the oral cavity. The advantage of this approach is that the incision is hidden within the oral mucosa, resulting in no visible scars on the surface of the skin in the neck area. Currently, this method is suitable for treating smaller thyroid nodules.

After the patient is placed under general anesthesia, the surgeon will make a small incision inside the patient’s oral cavity. Then, an endoscope is inserted through the incision until it reaches the neck where the thyroid is located. The endoscope displays images of the surgical area on a monitor, allowing the surgeon to assess the condition within the surgical field. Using minimally invasive instruments through the oral incision, the surgeon will ligate the thyroid’s blood vessels and separate the thyroid from surrounding vital structures. Finally, the excised thyroid gland is removed through the small incision.

Please note that the trans-oral thyroidectomy is a relatively new technique and may not be widely available or suitable for all patients. The specific surgical approach should be determined by a qualified surgeon based on individual patient factors and the extent of the thyroid condition.

At present, robotic-assisted minimally invasive surgery has become an important tool for thyroidectomy. Compared to conventional endoscopic devices, robotic arms provide surgeons with clearer and three-dimensional surgical images, as well as more precise and delicate surgical movements, overcoming limitations of conventional endoscopic surgery. Both the Bilateral Axillo-Breast Approach Thyroidectomy and Trans-Oral Thyroidectomy can be assisted by robotic arms.

The advantages of robotic-assisted surgery include the ability for the surgeon to control four robotic arms manipulating minimally invasive surgical instruments, as opposed to the two instruments used in traditional laparoscopic surgery. This allows for more accurate control and finer movements during the surgery. Additionally, the robotic arms’ surgical clamps are small, can rotate 540 degrees, and bend 270 degrees, allowing for greater flexibility in narrow spaces.

Therefore, for more complex thyroidectomies or cases where the thyroid gland is larger, the surgeon may recommend robotic-assisted surgery. However, it’s important to note that the use of robotic arms involves more complex and high-end instruments, resulting in higher surgical costs.

• The surgical incisions are small and inconspicuous (the surgeon hides the incisions in the areola, armpit, or oral cavity), making this procedure particularly suitable for young women.
• Due to the smaller incisions compared to conventional surgery, patients may experience less pain and have a faster recovery.

Wound Care

• After surgery, your wound has been covered with sterile dressings and gauze. Please keep the wound clean and dry.
• Since the surgical incision is covered with sterile dressings, you do not need to clean the wound regularly. However, if there is slight bleeding or oozing from the wound, you can clean it with disinfectant solution or saline solution, or notify the clinic nurse for assistance.
• You should follow the doctor’s advice and return to the clinic for follow-up and suture removal on the recommended date.
• You can resume your normal diet and daily activities.