ObjectiveTo investigate the feasibility and safety of using a custom-made needle-assisted retractor derived from a nerve monitoring monopolar ball-tip probe in endoscopic thyroidectomy by a gasless unilateral axillary approach (GUA). MethodsA retrospective analysis was performed on the clinical data and surgical procedures of 50 consecutive patients who underwent endoscopic thyroidectomy by GUA by a single surgeon in the Department of Thyroid Surgery, China-Japan Union Hospital of Jilin University from April 2023 to December 2023. Surgical experiences and operative techniques were summarized. ResultsAmong the 50 patients, there were 48 females and 2 males, with an age of (35.16±7.56) years. Forty-seven patients were diagnosed with papillary thyroid carcinoma, with a tumor diameter of (0.69±0.52) cm; 3 patients had benign nodules, with a maximum diameter of (2.67±0.58) cm. All patients underwent unilateral thyroid lobectomy (patients with malignancy additionally underwent central neck dissection). All surgery was successfully completed without conversion to open surgery. The operative time was (156.12±34.27) min. Postoperative complications included temporary hoarseness in 2 patients, subcutaneous effusion in 2 patients, and ipsilateral upper limb numbness in 1 patient. All complications recovered within one month. ConclusionsThe results of this study suggest that the in endoscopic thyroidectomy by a GUA approach demonstrates good feasibility and safety. Furthermore, it helps reduce the difficulty of the procedure, providing effective support for surgeons, especially beginners, to rapidly master this technique.
