American Thyroid Association Statement on Remote-Access Thyroid Surgery.

Journal Article (Journal Article;Review)

BACKGROUND: Remote-access techniques have been described over the recent years as a method of removing the thyroid gland without an incision in the neck. However, there is confusion related to the number of techniques available and the ideal patient selection criteria for a given technique. The aims of this review were to develop a simple classification of these approaches, describe the optimal patient selection criteria, evaluate the outcomes objectively, and define the barriers to adoption. METHODS: A review of the literature was performed to identify the described techniques. A simple classification was developed. Technical details, outcomes, and the learning curve were described. Expert opinion consensus was formulated regarding recommendations for patient selection and performance of remote-access thyroid surgery. RESULTS: Remote-access thyroid procedures can be categorized into endoscopic or robotic breast, bilateral axillo-breast, axillary, and facelift approaches. The experience in the United States involves the latter two techniques. The limited data in the literature suggest long operative times, a steep learning curve, and higher costs with remote-access thyroid surgery compared with conventional thyroidectomy. Nevertheless, a consensus was reached that, in appropriate hands, it can be a viable option for patients with unilateral small nodules who wish to avoid a neck incision. CONCLUSIONS: Remote-access thyroidectomy has a role in a small group of patients who fit strict selection criteria. These approaches require an additional level of expertise, and therefore should be done by surgeons performing a high volume of thyroid and robotic surgery.

Full Text

Duke Authors

Cited Authors

  • Berber, E; Bernet, V; Fahey, TJ; Kebebew, E; Shaha, A; Stack, BC; Stang, M; Steward, DL; Terris, DJ; American Thyroid Association Surgical Affairs Committee,

Published Date

  • March 2016

Published In

Volume / Issue

  • 26 / 3

Start / End Page

  • 331 - 337

PubMed ID

  • 26858014

Pubmed Central ID

  • PMC4994052

Electronic International Standard Serial Number (EISSN)

  • 1557-9077

Digital Object Identifier (DOI)

  • 10.1089/thy.2015.0407


  • eng

Conference Location

  • United States