Which endoscopic technique leaves no scar at all?

The transoral approach (TOETVA) enters through the lower lip vestibule, so there is no visible skin scar anywhere on the body. Axillary and chest approaches hide the incision where clothing covers it.

Endoscopic Thyroidectomy — Every Technique Explained

What Is Endoscopic Thyroidectomy

Endoscopic thyroidectomy removes the thyroid using a small camera and dedicated instruments passed through tiny, hidden incisions — instead of a large incision at the front of the neck. The key advantage is no visible neck scar, with faster recovery and less pain. When performed by an expert surgeon on suitable patients, safety and cancer clearance are comparable to open surgery.

Thailand plays a prominent international role in endoscopic thyroidectomy, especially the transoral approach (TOETVA), conceived and developed by Thai surgeons and now adopted worldwide.

Endoscopic Techniques

100% scar-free

Transoral — TOETVA

Transoral Endoscopic Thyroidectomy Vestibular Approach — three small incisions inside the lower lip, leaving no skin scar. Pioneered in Thailand and the most popular choice for patients prioritizing appearance.

Read about TOETVA →

Hidden under the arm

Transaxillary

Through an incision in the armpit, naturally concealed by the arm and clothing. Suited to one-sided nodules and widely practised across Asia.

Axillo-Breast-Shoulder

ABS Approach

Small incisions at the axilla, breast margin and shoulder give a wide working view, suited to certain nodules.

Bilateral & symmetric

BABA Approach

Bilateral Axillo-Breast Approach — through both axillae and breast margins for a symmetric midline view, suited to bilateral thyroid surgery.

Chest

Chest / Anterior Approach

Through an upper-chest incision hidden under clothing — another endoscopic option.

VANS / Retroauricular

Other techniques

VANS (Video-Assisted Neck Surgery) and the retroauricular (behind-the-ear) approach are further options selected by disease and patient suitability.

Robotic Thyroidectomy

The latest technology is robotic-assisted surgery, adding precision, 3D vision and articulated instruments in confined spaces — including Transoral Robotic Thyroidectomy (TORT), in which Thai surgeons were among the first in the world and the first in the country to succeed.

At a Glance

Aspect	Open surgery	Endoscopic surgery
Neck scar	Neck incision	None (hidden / scar-free with TOETVA)
Cosmetic outcome	Scar fades over time	Excellent, especially TOETVA
Safety	High standard	Comparable in expert hands
Very large mass / invasive cancer	Most suitable	Limited; requires patient selection
Operating time	Shorter	May be slightly longer

The right technique depends on the size and nature of the mass, biopsy results, anatomy and cosmetic priorities. Consult an experienced endocrine surgeon to plan together.

FAQ

How is endoscopic different from open surgery?

It hides the incision away from the neck using a camera and small instruments, rather than a direct neck incision. Safety is comparable in expert hands with suitable patient selection.

Which technique leaves no skin scar at all?

Transoral thyroidectomy (TOETVA) enters through the lower lip vestibule, leaving no visible skin scar anywhere.

Can everyone have endoscopic surgery?

Not everyone. Very large masses, clearly invasive cancer or certain anatomical limitations may be better suited to open surgery. The surgeon assesses each case individually.

This is general information, not individual medical advice. Please consult an endocrine surgeon.

Endoscopic Thyroidectomy