Overview
I. Anatomy and Biological Function The thyroid gland is a butterfly-shaped endocrine organ situated in the anterior neck, immediately inferior to the larynx (voice box). Its primary role is the extraction of iodine from the blood to synthesize hormones that govern the body's metabolism.
The gland is composed of two functional cell types:
1. Follicular Cells
2. C-Cells Pathogenesis:
Cancer occurs when these healthy cells undergo genetic mutations, leading to unregulated growth and the formation of a localized mass or tumour.
II. Histological Classifications Thyroid cancers are categorized into five primary types:
• Papillary Thyroid Cancer
• Follicular Thyroid Cancer
• Hürthle Cell Cancer
• Medullary Thyroid Cancer
• Anaplastic Thyroid Cancer
Diagnosis and Clinical Presentation
Common Symptoms
• Early Stage: Typically presents as a palpable mass in the thyroid region or a swelling in the lateral neck.
• Advanced Stage: Involvement of surrounding structures may lead to hoarseness (vocal cord nerve involvement), dysphagia (difficulty swallowing), or dyspnea (breathing difficulties).
Diagnostic Protocol
1. Serum Evaluation
2. Imaging: High-resolution Ultrasound (USG)
3. Biopsy: USG-guided Fine Needle Aspiration Cytology (FNAC)
4. Advanced Imaging
Treatment Approach
Scarless & Minimally Invasive Approaches These "remote access" techniques allow the surgeon to reach the thyroid through hidden entry points.
• Transoral (TORS): The surgery is done through small incisions inside the lower lip. This is the only truly "scarless" method as there is no external skin incision at all.
• Transaxillary: The entry point is through the armpit. This moves the scar away from the neck to a location that is naturally hidden by the arm.
• BABA (Bilateral Axillo-Breast): This uses four tiny incisions—two in the armpits and two near the chests/breasts. It provides the surgeon with an excellent, balanced view of the entire gland.
• Retroauricular: The incision is made behind the ear, similar to a facelift. The scar is hidden by the ear and the hairline.
The Technology Used Each of the approaches above can be performed using one of two technologies:
1. Endoscopic: The surgeon uses a tiny camera and specialized manual instruments.
2. Robotic-Assisted: The surgeon uses a high-definition 3D robotic system. This offers superior precision, better visualization of the nerves, and more steady movement in tight spaces compared to traditional endoscopy.