title: Single-incision endoscopic thyroidectomy by the axillary approach.
abstract: BACKGROUND
  As endoscopic skills and instruments continue to improve, many surgeons have begun to pay more attention to minimally invasive surgical techniques. Ever since Gagner first described endoscopic neck surgery, various techniques for endoscopic thyroidectomy have been attempted to improve the cosmetic results therein. The invasiveness of conventional endoscopic thyroidectomy is its main disadvantage, because the procedure requires a wide dissection just to reach the target site. More recently, single-incision laparoscopic surgery has received favorable attention due to the reduction of both scars and postoperative pain in various surgical fields. In this article, we report the initial clinical experiences with single-incision endoscopic thyroidectomies (SIETs) that have been performed via the axillary approach.
  
  
  METHODS
  We performed multiple SIETs via the axillary approach to overcome the known disadvantages of conventional endoscopic thyroidectomy. Four consecutive patients underwent SIETs that were undertaken using the standard laparoscopic instruments at our institution. In this study, we analyzed tumor size, operative time, length of hospital stay, complications, and cosmetic results.
  
  
  RESULTS
  All patients were women and had undergone successful SIET operations. The mean age was 35.6 ± 11.4 years (range, 19-43 years), and the mean time of the operation was 160 ± 19.2 minutes (range 145-185 minutes). There were no reported complications, and all the patients were very satisfied with the cosmetic results.
  
  
  CONCLUSIONS
  SIET via the axillary approach is safe and feasible for the treatment of patients with thyroid tumors.
authors.affiliation: Department of Surgery, Bucheon St. Mary's Hospital, The Catholic University of Korea, Bucheon, Korea.
authors.forename: Dosang
authors.initials: D
authors.lastname: Lee
authors.forename: Yuhee
authors.initials: Y
authors.lastname: Nam
authors.forename: Kiyoung
authors.initials: K
authors.lastname: Sung
mesh_terms: D000236:Adenoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D001365:Axilla; D002921:Cicatrix / Q000209:etiology / Q000517:prevention & control*; D015331:Cohort Studies; D004724:Endoscopy; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult