Evolution of Endoscopic Thyroidectomy: Will a Novel Single Channel Flexible Endoscopic Approach Change the Treatment Paradigm?

Endoscopic thyroidectomy has evolved from a hybrid approach utilizing a laparoscopic assistant and robotic-assistance to pure flexible endoscopic thyroidectomy without laparoscopic assistance. However, all the hybrid approaches are complicated and results in scar somewhere on the body surface. Current experimental and clinical studies focus on the implementation of new minimally invasive approaches such as flexible endoscopic thyroidectomy which leaves no scar on the body surface and easier to perform. Flexible endoscopic thyroidectomy is seeming to be a relatively safe and feasible technique with good outcomes. However, more research, particularly using newly developed tools to further improve this technique, and large scaled practice is needed to make it more available to patients worldwide. This article summarizes established endoscopic thyroidectomy techniques and highlight the pros and cons of different available endoscopic approaches to thyroid resection, and discussed how flexible endoscopic thyroidectomy compares to the well establish techniques and future perspective.