Introduction and objective:

In the last years the development of remote access techniques for thyroid and parathyroid surgery has led to the consolidation of the four configurations that are currently used as standards. The objective of this review is to describe the accumulated experience in thyroidectomy and parathyroidectomy by axillary, bilateral axillo-breast, retroauricular and transoral approaches, as well as to present the results published by the different groups.

Synthesis:

The axillary approach was the first to be described and it has the oldest and some of the biggest series, which reproduce the standard results of open surgery for the same indications. However, in recent years it has been progresively abandoned in favor of alternative approaches. The retroauricular approach was initially described for thyroid surgery, but its indications have migrated to another cervical diseases. The bilateral axillo-breast approach has been widely used in thyroid surgery and reproduces not only the demanding standards regarding recurrent laryngeal nerve lesions and postoperative hypoparatyroidism, but also the oncological standards in the surgical management of differentiated thyroid carcinoma. The transoral / transvestibular approach, the last to arrive, is expanding and it is potentially applicable to most thyroid and parathyroid surgical cases.

Conclusions:

Remote access techniques have proven to be safe and effective. The volume of activity already published and the results would already make them standard procedures, although it is still necessary to verify the reproducibility of the results in prospective multicenter series.

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