This question can be answered briefly and succinctly with “no”. However, since methods have increasingly been developed in recent years that make it possible, under certain conditions, to remove the thyroid gland without making an incision in the neck, I would like to explain these in more detail.

With this method, the mucous membrane between the lower lip and lower jaw is opened in three places with incisions up to 1.5 cm in size. The fatty connective tissue under the skin in the neck and chin area is then injected with around 300ml of fluid to create a fluid-filled subcutaneous space (hydrodissection is the technical term for this procedure). After this procedure, three trocars are inserted and the thyroid is operated on using a camera and two long instruments, as in laparoscopic abdominal surgery. In my opinion, the problem with this technique is that it can only be used for thyroid nodules of a certain size (the specimen must be able to be recovered in some way – without a neck incision) and that lymph node surgery is not carried out to the same quality as in the open procedure and that the oral cavity is a non-sterile space from which germs are carried into a previously sterile surgical area.

Like TOETVA, ABBA is an endoscopic surgical procedure, the difference is that the skin incisions are made for access in the armpit and both breasts. A relatively long distance must then be overcome under the skin until the surgical area on the neck is reached. Here too, a not inconsiderable subcutaneous trauma occurs when the instruments are tunneled. In my opinion, according to TOETVA, the limitations are the tumor size and the feasibility of adequate oncological lymph node surgery.

Another endoscopic technique I would like to mention is the retroauricular approach (behind the ear) to the thyroid. In this type of operation, the skin incisions are made behind the ear; this technique also creates a huge wound area in the subcutaneous connective tissue corresponding to the long paths that separate the skin incision from the target surgical area. The limitations of this method, in line with the aforementioned techniques, are the tumor size and the feasibility of radical lymph node surgery. Based on the previous considerations, I do not use any of the methods mentioned above out of conviction. A single short skin incision in an optimal position, usually no longer than 4cm, brings very good cosmetic results. The scar is usually barely or not at all visible after a year from the time the thyroid was removed.