Surgery

Remote Access “Scarless” Thyroid Surgery

The Mount Sinai Endocrine Surgery team is at the forefront of innovation. Our team has pioneered novel ways to reach the thyroid gland, using remote access, or “hidden scar” techniques.  Our surgeons helped develop and introduce these techniques to the United States and have had several “firsts” including:

  • 1998 – 1st endoscopic thyroidectomy in the United States (2nd in the world)
  • 2009 – 1st endoscopic transaxillary endoscopic thyroidectomy
  • 2015 – 1st robotic bilateral axilla breast approach (BABA) thyroidectomy
  • 2016 – 1st robotic BABA lymph node dissection for thyroid cancer
  • 2016 - 2nd  transoral endoscopic thyroidectomy
  • 2018 – 1st robotic BABA total thyroidectomy and bilateral modified lymph node dissection

These minimally invasive thyroid techniques do not leave a visible scar on the neck as the incisions are made in remote locations; a camera provides a magnified view of the operative field to permit safe removal of the thyroid gland. We are one of the few endocrine programs in the world to offer several hidden-scar approaches to thyroid gland removal, including transoral (mouth), breast, and transaxillary (armpit) approaches. Watch this video on minimally invasive thyroid techniques

Types of Remote Access Procedures

Mount Sinai is the only health system in the United States that can offer all three types of the latest endoscopic and robotic techniques:

  • Transoral endoscopic thyroidectomy (TOETVA)—the transoral endoscopic thyroidectomy approach (TOETVA) is a novel technique for performing minimally invasive node removal of your thyroid gland through hidden incisions inside and underneath the lower lip. An endoscopic camera and instruments are inserted through the hidden incisions to remove the thyroid gland. With this approach there is no incision or scar on the neck; the incisions in the oral cavity heal very quickly and are not visible within 7-10 days of surgery. Watch this video on Transoral endoscopic thyroidectomy (TOETVA) .
  • Endoscopic transaxillary approach—this is an under arm approach. Your surgeon makes a small incision under your arm so that the scar will be hidden. This procedure may be used for partial or total thyroid removal for early stage thyroid cancer or Graves’ disease.
  • Robotic Bilateral Axillary Breast Approach (BABA)—the latest robotic technology for large benign thyroid disorders and advanced thyroid cancers uses four small incisions on the breasts and underarms. The BABA approach uses robotic instruments and a 3D camera for your optimal safety and to ensure effectiveness of the procedure. True pioneers in this field, Mount Sinai surgeons performed the first BABA procedures in the United States in 2015, including thyroid and modified radical neck lymph node dissection surgeries.

Why Opt for These Procedures?

Our hidden-scar techniques for thyroidectomy eliminate the after effects of open surgery and offer the benefit of reduced recovery time. Additionally, inconspicuous cosmetic outcomes are a welcome result of the carefully placed small incisions.

Satisfied patients share their scarless results in these photos.

Complete Care

Our specialists include surgeons, endocrinologists, radiologists, medical oncologists, geneticists and others who work together to provide you:

  • A comprehensive evaluation
  • A personalized treatment plan
  • Integrated care with multiple thyroid specialists
  • Minimally invasive thyroid surgery
  • Robotic thyroid surgery
  • Intraoperative nerve monitoring
  • Participation with the Collaborative Endocrine Surgery Quality Improvement Program (national quality initiative)
  • Surgeon-performed ultrasonography during your visit
  • On-site thyroid nodule biopsy with immediate onsite diagnosis
  • Outpatient thyroid surgery
  • Multiple practice locations
  • Expert faculty/surgeons
  • World class health system with data integration

Patient Safety

Your safety is our top priority. We actively participate with the Collaborative Endocrine Surgery Quality Improvement Program (CESQIP), a national quality initiative that is managed by the American Association of Endocrine Surgeons. CESQIP allows us, along with other surgeons and hospitals, to closely monitor outcomes with an implicit goal of improving surgical outcomes for you, our patients.