The method involves a tiny incision in the armpit. An endoscopy balloon is inserted through that incision and inflated, and this creates a space in the chest and neck area. Two additional small cuts are made in the armpit for insertion of the small camera and surgical instruments that will allow for viewing and removing the nodule or thyroid lobe.
Conventional thyroid surgery typically requires a fairly long incision -- as much as 4 to 6 inches or more -- across the neck area. While doctors are usually careful to make the incision in a fold in the neck, the scar is often visible for quite a bit of time after the surgery, until it heals and recedes into the fold.
The underarm endoscopic surgery, involves very little bleeding, minimal incisions, and no visible scars in the neck.
“Considering that a large number of goitre patients needing surgery are young and middle-aged women, there is a major role for endoscopic surgery in the management of this disease,” said one Indian surgeon.
In India, a country that has a high rate of thyroid disease due to iodine deficiency and endemic goiter, the approach is mainly being used for nodules and goiter, and primarily for removal of only part of the thyroid. Smaller glands are better candidates for this surgery as well.
The surgery is gaining popularity in other parts of the world as well, primarily for removal of benign nodules.
Other endoscopic approaches to thyroid surgery include the "breast approach" and "chest approach."
Experts are still looking at whether endoscopic axillary thyroidectomy is effective for total thyroidectomy -- removal of the entire thyroid gland.
Source: "Thyroid out, not a scratch on neck." The Telegraph: Calcutta India, November 12, 2005
