Clinical experinces of endoscopic thyroidectomy in 73 cases

[Objective] To further evaluate the clinical application of video assisted endoscopic thyroidectomy. [Methods] Thyroidectomy with endoscopic instruments through chest-wall approach was done for 73 patients from July 2002 to December 2004. The age of the patients was from 16 to 53 years old (mean 33). Three trocars were placed above both nipples and at the point of between nipples respectively. Subcutaneous space was built between nipples and neck. CO2 was inflated at the pressure of 6 mmHg, Dissection of thyroid, division and homeostasis of vessels and parenchyma and resection of thyroid was all done by using ultrasonically activate scalpel with adenoma; cyst; multiple nodes and cancer of thyroid. [Results] All 73 cases of operation were successful with no conversion. 18 patients experienced bilateral subtotle lobe thyroidectomy, The others had unilateral subtotle lobectomy or partial lobectomy. Pathologically there were 32 cases of poiter, 27 cases of adenoma, 5 cases of papillary cancer, 2 cases of hyperthyroid, 6 cases of cyst, 1 case of Hashimoto disease. There were no severe surgical complications such as nerve damage or hemorrhage. average operation duration was (160±32) min for the former 39 cases and (85±13.3) min for the current 34 cases. The mean time of hospitalization after operation was (4±0.5) days. [Conclusions] With the advantages of minimal and hidden incision, sooner recovery and satisfactory cosmetic effect, The endoscopic thyroidectomy will prevail in selected cases in the future.