Endoscopic thyroidectomy – Is it safe and reliable? – Experience and results at a tertiary care centre in India

INTRODUCTION: Minimal access thyroidectomy can be performed using several approaches, including transaxillary, breast-axilla and transoral endoscopic thyroidectomy (ET) vestibular approach (TOETVA). These techniques are designed to minimise visible scarring and enhance cosmetic outcomes. Endoscopy allows magnification, enabling improved visualisation of the recurrent laryngeal nerve (RLN) and parathyroid glands. PATIENTS AND METHODS: This retrospective study evaluates the safety, reliability and complication rates of ET and proposes criteria for selecting the optimal approach. 266 patients who underwent minimal access thyroidectomy from May 2016 to May 2025 were included. Fine-needle aspiration cytology indicated benign aetiology (Bethesda Class 2) in 171 patients, indeterminate aetiology (Bethesda Class 3 and 4) in 71 patients and 24 patients were highly suspicious or proven malignancy (Bethesda Class 5 and 6). The primary indication was a solitary thyroid nodule (STN) in 204 patients, multinodular or bilobar lesions in 62 patients and malignancy in 24 patients. RESULTS: TOETVA was performed in 227 patients (nodule sizes 2-6 cm, 86%