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

Introduction: Inexperienced endoscope holder usually affects the time and quality of endoscopic thyroidectomy by bilateral areola approach.In this study, several lens holding techniques were summarized and evaluated.Methods: Two hundred eligible patients were enrolled in two time periods: June 2015-June 2018 (Control group) and September 2019-Fubrurary 2021 (Improved group).Surgical approach was unilateral lobectomy and isthmus resection plus ipsilateral cervical central lymph nodes dissection via bilateral areola approach of endoscopic thyroidectomy, then the perioperative indicators were compared.Postoperative complications included temporary hoarseness, transient hypoparathyroidism and postoperative subcutaneous effusion. Results:The operation time of stage 1, stage 2 and stage 3 in the improved group was significantly shorter than those in the control group.The intraoperative blood loss, postoperative hospitalization time and the indwelling time of drainage tube were no significant difference between the two groups.Complications in the control group included 14 cases of temporary hoarseness, 14 cases of transient hypoparathyroidism, and 7 cases of postoperative subcutaneous effusion.And the improved group included 12 cases, 11 cases, and 5 case, respectively. Conclusion:The endoscopic lens holding technique can shorten the operation time, it's suitable for novices.