The Improved Techniques of Holding the Lens in Endoscopic Thyroidectomy via Bilateral Areola Approach

Abstract

\n Background: Inexperienced endoscope holder often greatly affect the time and quality of endoscopic thyroidectomy (ET) via bilateral areola approach. We summarized some techniques of holding the endoscopic lens to evaluate the value of the technique in ET.Methods: We retrospectively enrolled 200 eligible patients during two time peroids: 2015.6-2018.6 (Control group:inexperienced endoscope holder,n = 100) and 2019.9-2021.2 (Improved group:assistants who master the techniques of holding the endoscopic lens,n = 100). Surgery approach:unilateral lobectomy and isthmus resection plus ipsilateral cervical central lymph nodes dissection via bilateral areola approach of ET. Perioperative indicators included Volume of intraoperative blood loss,the time of three stages in the operation, the indwelling time of drainage tube and postoperative hospitalization time were compared. Postoperative complications were simultaneously compared involved temporary hoarseness, tetany, postoperative bleeding, postoperative infection and postoperative subcutaneous effusion.Results: The time of stage 1 (p < 0.001), stage 2 (p < 0.001) and stage 3 (p < 0.001) in the operation in improved group were significantly shorter than those in control group. The volume of intraoperative blood loss was smaller (p < 0.001), postoperative hospitalization time was shorter (p < 0.001) and the indwelling time of drainage tube was shorter (p < 0.001) for improved group. In terms of postoperative complications, the control group had more cases of temporary hoarseness (p = 0.002), tetany (p = 0.008) and postprocedure subcutaneous effusion (p = 0.009), but there was no difference in postoperative bleeding (p = 0.477) and infection (p = 1.000) between the two groups.Conclusions: The skills of holding the endoscopic lens which shorten the operation time and improve the quality of the operation are effective and suitable for novices.