"Stealth surgery": transaxillary subcutaneous endoscopic excision of benign neck lesions.
BACKGROUND
Benign neck lesions are traditionally removed through an overlying incision. The resultant scar can be aesthetically displeasing. We previously reported our experience with a transaxillary subcutaneous endoscopic approach for management of torticollis. We now report a similar technique for removal of benign lesions of the neck.


METHODS
The study uses a retrospective review of 5 elective transaxillary endoscopic procedures from March to December 2006. The lesions included an enlarged cervical lymph node, thyroglossal duct cyst, dermoid cyst, ectopic dilated neck vein, and a parathyroid adenoma. Outcome measures included need for conversion, cosmetic outcome, and complications.


RESULTS
All procedures were successfully completed using the endoscopic approach. Postoperative pain was controlled with acetaminophen, and all patients were discharged from the hospital the same day. There were no intraoperative complications. The patient who had a thyroglossal cyst removed developed a postoperative seroma that resolved spontaneously. All families were pleased with the cosmetic results.


CONCLUSIONS
A transaxillary subcutaneous endoscopic approach can be applied effectively to a variety of benign lesions of the neck, allowing adequate exposure for dissection, and resulting in a quick recovery. Neck scarring is absent, with small scars well hidden in the axilla.
Dutta
Sanjeev
S
Department of Surgery, Division of Pediatric Surgery, Lucile Packard Children's Hospital, Stanford University, CA 94305-5733, USA. sduttal@stanford.edu
Slater
Bethany
B
Butler
Marilyn
M
Albanese
Craig T
CT
D000236:Adenoma / Q000601:surgery; D000293:Adolescent; D001365:Axilla; D002648:Child; D002675:Child, Preschool; D003884:Dermoid Cyst / Q000601:surgery; D017558:Elective Surgical Procedures; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery; D006801:Humans; D008206:Lymphatic Diseases / Q000601:surgery; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009333:Neck / Q000601:surgery*; D010282:Parathyroid Neoplasms / Q000601:surgery; D012189:Retrospective Studies; D040521:Subcutaneous Tissue; D013955:Thyroglossal Cyst / Q000601:surgery; D014680:Veins / Q000601:surgery