Conventional surgery for thyroid disease requires long skin incisions and can lead to prominent scars of the neck, adhesions, hypoesthesia, and paresthesia. To overcome these problems we performed an endoscopic thyroidectomy via an axillo-bilateral breast approach.

Seventy patients with benign thyroid nodules by fine needle aspiration were selected. Patients underwent endoscopic thyroidectomy via axillo-bilateral breast approach from May, 2003, through November, 2007.

Operations included 67 lobectomies, 1 isthmectomy, and 2 total thyroidectomies. Two cases were converted to an open thyroidectomy because of bleeding. The mean operating time was 90.6 min (range, 60~170). The mean length of hospital stay was 6.39 days (range, 4~12), and the mean duration of drainage was 3.87 days (range, 2~9). Postoperative hematoma for 3 patients was observed, but absorbed spontaneously. Two patients complained of hoarseness and 1 patient had vocal cord palsy, but these disappeared during follow-up.

This approach resulted in satisfactory cosmetic results and no significant complications. We believe that endoscopic thyroidectomy via an axillo-bilateral breast approach is feasible and safe.