Remote Access Thyroidectomy

Over the past two and a half decades, many endoscopic and robotic surgical techniques have been developed and attempted to avoid the visible transverse cervical scar associated with standard open thyroidectomy (Patel et al., Ann Surg 271(3):e21–e93, 2020). The most commonly performed of these so-called “remote access” techniques in the United States utilize incisions placed away from the low anterior neck including the transaxillary, bilateral axillo-breast (BABA), retroauricular (“facelift”), and transoral approaches. The literature to date suggests comparable safety and efficacy outcomes compared to traditional open thyroidectomy when these techniques are applied in selected patients (Berber et al., Thyroid 26(3):331–337, 2016). This focused chapter explores the rationale and indications for these approaches, as well as provide a descriptive overview of some of the more commonly performed remote-access thyroidectomy approaches in the U.S. with a particular emphasis on the most recent transoral technique which has rapidly gained popularity.