Which is better: endoscopic thyroid surgery or conventional open thyroid surgery?

Generally speaking, there is no absolute "better" option between endoscopic thyroid surgery and conventional open surgery. Each approach has its own advantages, and the choice should be based on tumor characteristics, patient preferences, and the surgeon's expertise. The detailed analysis is as follows:

The key differences between the two procedures lie in incision location, invasiveness, and indications. Conventional surgery requires a 3-5 cm incision in the neck, allowing direct visualization of the thyroid gland and surrounding tissues. This provides a clear surgical field and is suitable for larger tumors, suspected or confirmed thyroid cancer requiring lymph node dissection. However, it leaves a visible scar on the neck and typically involves a longer recovery period.

In contrast, endoscopic thyroid surgery uses small incisions made in concealed areas (e.g., axilla, chest, or oral cavity), with surgical instruments guided by a camera. This approach avoids visible neck scarring, offers better cosmetic outcomes, causes less trauma, results in milder postoperative pain, and allows faster recovery. However, it demands higher technical skill from the surgeon, may take longer to perform, and is unsuitable for patients with very large tumors, severe adhesions between the thyroid and surrounding tissues, or advanced thyroid cancer—otherwise, it could increase surgical risks or result in incomplete tumor removal.

In addition, patient preference regarding cosmetic appearance is an important consideration. Patients who prioritize neck aesthetics and meet the criteria for endoscopic surgery may prefer this minimally invasive option. Conversely, if the tumor is complex or the surgeon determines that open surgery would be safer and more thorough, conventional surgery should be recommended.

Therefore, the choice of surgical method should not follow trends blindly. It is essential to have thorough discussions with the treating physician and make a personalized decision based on tumor size, nature, location, and individual cosmetic concerns.