Video-assisted endoscopic endocrine neck surgery with a benefit of cosmesis: a new technique using a totally gasless anterior neck skin lifting method.

Abstract

The incidence of endocrine diseases in the neck is markedly higher in women than in men, and operations for these diseases sometimes result in a conspicuous scar on the anterior neck that is normally an exposed area when open-neck clothing is worn. Therefore, a surgical technique with consideration to the cosmetic viewpoint has been desirable. By widely generalizing endoscopic surgery, endoscopic thyroid and parathyroid surgery has developed and has been increasingly refined in recent years. We originally developed video-assisted neck surgery using an anterior neck skin lifting method(termed the VANS method)for thyroid and parathyroid tumors in March, 1998 and have experienced more than 150 cases. In thyroid tumors, the surgical indication is a strictly defined benign single nodule measuring less than 6 cm in diameter that is located in the hemi lobe while micropapillary carcinoma measuring less than 1 cm in diameter with no regional lymph node swelling. In parathyroid tumors, the VANS method is indicated for a tumor that is preoperatively made an accurate localization. According to a questionnaire, a hundred percent of the patients who underwent the VANS method expressed cosmetic satisfaction. The VANS method is believed to be feasible, safe, and practical with cosmetic benefits.