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Trans-axillary intra-operative ultrasound cystic drainage and thyroid lobectomy: a new endoscopic approach

Bulky complex cystic thyroid lesions are common, and an endoscopic approach can be a challenge due to technical limitations. Trans-axillary lobectomy is a current practice in our team. Big lobes can be very difficult to mobilize and remain still an indication for cervicotomy. Whenever there is a large cystic component, we manage these cases with trans-axillary intra-operative ultrasound (IOUS) and trans-axillary endoscopic drainage, in order to perform a safer thyroid lobectomy. As far as we are concern this issue has not yet been published in scientific papers. We describe the technique and the results of a series of three cases.