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Review article
Surgical approaches to thyroid
Abordajes en cirugía tiroidea
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Pablo Moreno Llorente
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25108pml@gmail.com

Corresponding author.
, Erick A. Gonzales Laguado, Marta Alberich Prats, José Manuel Francos Martínez, Arantxa García Barrasa
Unidad de Cirugía Endocrina, Hospital Universitari de Bellvitge, Universidad de Barcelona (UB), L’Hospitalet de Llobregat, Barcelona, Spain
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Received 26 June 2020. Accepted 11 August 2020
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Table 1. Characteristics of the remote thyroid approaches.
Abstract

Thyroidectomy is the most frequent procedure in endocrine surgery. The conventional approach through a collar incision, as described by Kocher in 19th century, has become the “gold standard”. It is continuously evolving in spite of having been shown to be safe and efficient many years ago, with quality standards that are difficult to beat.

Endoscopic and robotic surgery have developed “new approaches” to the thyroid in order to improve the cosmetic results, even aiming for invisible scars.

We have made a thorough review of most of them with the intention of understanding their benefits and drawbacks.

Currently none of these “new approaches” have been shown to be better than conventional open thyroidectomy beyond offering a better cosmetic result. Besides, only a small percentage of patients can benefit of them. However, most of these approaches will remain if they treat the diseased thyroid and also improve the quality of life of our patients.

Keywords:
Thyroidectomy
Endoscopic surgery
Robotic surgery
Remote access
Scar
Resumen

La tiroidectomía es el procedimiento más común en cirugía endocrina. La incisión cervical de Kocher es el «gold standard» para abordar el tiroides desde que fuera presentado por este a finales del siglo xix. Desde entonces, la tiroidectomía tal y como ahora la conocemos ha demostrado ser una técnica eficaz y segura, pero no por ello ha dejado de evolucionar habiendo conseguido además unos indicadores de calidad difíciles de superar.

El advenimiento de nuevas tecnologías y un intento constante por mejorar la cosmética de la cirugía han dado lugar a «nuevos abordajes». En este artículo hacemos una revisión de estos intentando mostrar sus beneficios y limitaciones.

Actualmente, ninguno ha demostrado ser mejor que la cirugía convencional más allá del valor añadido del beneficio cosmético, pero permanecerán si demuestran que han sido eficientes en el tratamiento de la enfermedad y en mejorar la calidad de vida de nuestros pacientes.

Palabras clave:
Tiroidectomía
Cirugía endoscópica
Cirugía robótica
Acceso remoto
Cicatriz

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