“Elastic Stretch Cavity Building” System in Endoscopic Thyroidectomy of Giant Thyroid Tumors

OBJECTIVE: To analyze the clinical characteristics of patients with large thyroid tumors underwent endoscopic thyroidectomy using the “elastic stretch cavity builder” system. METHODS: This retrospective case series study included thyroid tumor patients admitted to the Ningbo Medical Center Li Hui li Hospital between September 2017 and November 2021. The self-developed “elastic stretch cavity builder” was used to elastically lift the anterior cervical flap, combined with low-pressure (3 mmHg) high-flow CO2 inflation, and create a working cavity for endoscopic thyroidectomy. RESULTS: This study included 13 patients for analysis. The endoscopic thyroidectomy duration was 92-170 min (mean, 123 ± 24min). The maximum transverse plane diameter of the glands was 5.0-6.2 cm (mean, 5.3 ± 0.3 cm). The maximum sagittal plane diameter was 6.8-10.0 cm (mean, 7.6 ± 0.9 cm). After the “elastic stretch cavity builder” lifted the cervical flap, the height of the subcutaneous region was increased by 1.3 ± 0.2cm without affecting cervical activity. There was no residual scar in the anterior cervical skin puncture hole. All patients were satisfied with the cosmetic with the cosmetic satisfaction score was 3.4 ± 0.5. CONCLUSION: The novel mixed cavity building model established by the “elastic stretch cavity builder” might provide the surgeon with additional longitudinal cervical operating space while improving the stability of the space and saving human effort.