Programmed Chest-Breast Approach Endoscopic Lateral Neck Dissection for Papillary Thyroid Carcinoma

Abstract

Introduction:

Papillary thyroid carcinoma (PTC) frequently involves lateral neck lymph node metastasis, necessitating precise dissection. Traditional endoscopic approaches face challenges in compartmental exposure and nerve preservation. This video presents the innovative “six-step suspension method” for endoscopic lateral neck dissection (LND) via the chest-breast approach, a programmed technique designed to enhance systematic dissection of IIa, IIb, III, IV, and Vb regions while minimizing variability.

Materials and Methods:

The procedure employed a fixed seven-step protocol under endoscopic guidance: Skin flap creation and space establishment；Identification of key landmarks；Dissection of arterial triangle；Space creation for III-Vb regions；Dissection of III-Vb regions；Space creation for II region；Dissection of II region (IIa and IIb)；Innovations included suspension-based space maintenance (replacing retractors) and intraoperative ultrasound fusion with preoperative CT for navigation (Patent ZL201822264072).

Results:

The programmed chest-breast approach for endoscopic LND offers a systematic, innovative method for treating PTC.

Conclusions:

The programmed chest-breast approach with suspension techniques ensures thorough, safe LND through compartmentalized dissection, reducing operative time and complications. It offers superior aesthetic outcomes (scarless neck incision) and represents an international advancement in endoscopic thyroid surgery, validated by clinical outcomes.

Patient consent:

Patient consent was obtained for video recording and publication.

Funding Sources:

The video received financial support from: National Key Clinical Specialty Construction Project.

Verification:

I confirm that all declarations are accurate to the best of my knowledge. Any omissions or inaccuracies will be promptly corrected upon notification.

I confirm that the video has been submitted solely to this journal and is not published, in press, or submitted elsewhere.

I confirm that all the research meets the ethical guidelines, including adherence to the legal requirements of the study country.

Author Disclosure Statement:

For Video Submission to VE.

Nan Xu, corresponding author of the video titled “Programmed Chest-Breast Approach Endoscopic Lateral Neck Dissection for Papillary Thyroid Carcinoma” (Submission ID: VE-2025–0015), hereby declares the following commercial associations and potential conflicts of interest related to this work during the past 2 years (2023–2025).

Runtime of video: 9 min 35 s.