Endoscopic Thyroidectomy with Miniature Tools in a Pig Model

Abstract

Objective: Assess the feasibility of direct endoscopic thyroidectomy in a porcine model using CO₂ pneumodissection, miniature cameras and endoscopic tools.

Method: The study was conducted during the second half of 2011. Endoscopic thyroid dissection was performed in a porcine model with CO₂ pneumodissection, using cameras and endoscopic tools ranging in diameter between 2 and 5 mm.

Results: Thyroid dissection was performed in a total of 10 pigs. Two were “open” procedures to learn the porcine anatomy. Eight were endoscopic procedures. Of them 5 used three 5-mm incisions and 3 used three 2- to 3-mm incisions for surgical tools and a 5-mm incision for the endoscopic camera. In all cases the thyroid was completely dissected with the recurrent laryngeal nerve (RLN) identified and preserved. In 5 cases the thyroid was removed through the floor of the mouth. There was no major bleeding in the live pigs, and all the vital structures were identified and preserved.

Conclusion: Endoscopic thyroidectomy using miniature camera and tools in a porcine model seems to be feasible without major complications. The advantages of this approach include minimal scars and improved visualization. We believe that there is room for further development of minimal invasive techniques for thyroid surgery.