title: Gasless single incision trans-axillary thyroidectomy: The feasibility and safety of a hypo-morbid endoscopic thyroidectomy technique.
abstract: BACKGROUND
  A range of minimally invasive endoscopic techniques (gas dependent and gasless) have been attempted for thyroidectomy in the past two decades. In this context, we evaluated the feasibility and safety of our technique of a gasless trans-axillary thyroidectomy.
  
  
  METHODS
  This retrospective study from the Department of Endocrine and metabolic surgery in Southern India included 15 cases. The details of operative technique, intra and postoperative data were documented in all the cases. Only cases with benign thyroid nodules were included. Exclusion criteria were diffuse toxic goiters (Graves' disease), thyroid cancer, > 6 cm nodules, recurrent goitres and patients with shoulder joint pathology. Statistical analysis was done with SPSS software 12.0 version.
  
  
  RESULTS
  F:M -14:2. Mean age of the patient group was 26.4 years (15-52). Mean operative time was 123.4 (82-206) minutes. The only specific complications were induration in the infraclavicular area between axillary incision and thyroid region, prolonged wound drainage and stiffness in lower 3(rd) of sternocleidomastoid. Wound drainage lasted for 5.4 days (4 -8). There was no significant operative morbidity.
  
  
  CONCLUSIONS
  This gasless trans-axillary technique for nodular goitres is safe and effective in the hands of an experienced thyroid surgeon.
authors.affiliation: Department of Endocrine and Metabolic Surgery, Mamata Medical College and Hospital, Khammam, Andhra Pradesh, India.
authors.forename: Panchangam R K
authors.initials: PR
authors.lastname: Bhargav
authors.forename: Uday S
authors.initials: US
authors.lastname: Kumbhar
authors.forename: G
authors.initials: G
authors.lastname: Satyam
authors.forename: K B
authors.initials: KB
authors.lastname: Gayathri
keywords: Endoscopic thyroidectomy; Hhypercarbia; Nnodular goitere; Ttrans-axillary thyroidectomy; gGasless technique
references.citation: Surg Laparosc Endosc Percutan Tech. 2011 Aug;21(4):223-9
references.pmid: 21857469
references.citation: Thyroid. 2002 Aug;12(8):703-6
references.pmid: 12225638
references.citation: J Am Coll Surg. 2003 Feb;196(2):189-95
references.pmid: 12595044
references.citation: Endocr J. 2009;56(3):361-9
references.pmid: 19139596
references.citation: Surg Endosc. 2008 Aug;22(8):1871-5
references.pmid: 18163167
references.citation: Otolaryngol Clin North Am. 2008 Dec;41(6):1059-67, vii
references.pmid: 19040968
references.citation: Surg Endosc. 2003 Nov;17(11):1808-11
references.pmid: 14508667
references.citation: Indian J Surg. 2010 Aug;72(4):336-8
references.pmid: 21938199
references.citation: J Laparoendosc Adv Surg Tech A. 2003 Oct;13(5):295-9
references.pmid: 14617385
references.citation: J Laparoendosc Adv Surg Tech A. 2007 Feb;17(1):21-5
references.pmid: 17362173
references.citation: Arch Otolaryngol Head Neck Surg. 2012 Feb;138(2):113-7
references.pmid: 22351858
references.citation: World J Surg. 2009 Apr;33(4):767-72
references.pmid: 19198933
references.citation: Otolaryngol Clin North Am. 2010 Apr;43(2):381-8, ix-x
references.pmid: 20510721
references.citation: Arch Surg. 2010 Aug;145(8):717-20
references.pmid: 20713921
references.citation: Anesth Analg. 1997 May;84(5):1154-6
references.pmid: 9141952
references.citation: World J Surg. 2002 Aug;26(8):972-5
references.pmid: 12016476
references.citation: Surg Laparosc Endosc Percutan Tech. 2003 Jun;13(3):196-201
references.pmid: 12819505