A New Retractor for Gasless Endoscopic Thyroidectomy

Introdiction: Endoscopic thyroidectomy had been developed for nearly 20 years. The aim of this technique is improving cosmetic results. In Thailand, most of the endoscopic thyroidectomy techniques are gas technique using CO2 insufflation for working space creation. There had been no previous report of gasless technique with infraclavicular approach in Thailand. The interesting advantage of this technique is no risk of gas insufflation-related complications. To perform gasless technique, a skin flap lifting retractor is inevitably needed. In Japan, the retractor was modified from Kirschner wires and hanging by chains and bar system. Unfortunately, it is not available in Thailand, so we want to invent a new retractor for gasless endoscopic thyroidectomy in Thailand. To invent a new retractor for gasless endoscopic thyroidectomy. Method: The retractor instruments were designed to easily installed to the operating bed for using in gasless endoscopic thyroidectomy. After the retractor set was successfully produced by a factory as planning then it was tested for practical use in the operating room. The final instruments after correction were used in endoscopic thyroidectomy at Thammasat university hospital. Results: The retractor was successfully invented and there had been 7 patients underwent gasless endoscopic thyroidectomy using this retractor. There was no any complication related to the retractor. Discussion and Conclusion: For inventing a new surgical instrument, patient’s safety is the most concerned. This study shows that this new retractor is safe for gasless endoscopic thyroidectomy operation.