Surgeons perform 'scarless' thyroid surgery

Doctors say incisions are hidden in patient's armpit


DETROIT – Michelle Livingston of Woodhaven, Mich., had her first thyroid problem eight years ago.  It started with a lump she found on the left side of her neck while drinking some juice. 

After an evaluation, it was decided she would need the left side of her thyroid gland removed.  At that time, the only way to do the surgery was through an incision across the front of the neck. 

Livingston's scar healed well, but she was still self-conscious. 

"Anytime you have surgery, you think it's this flag hanging out there for the world to see," said Livingston.

Livingston thought her thyroid problems were all behind her until last year. 

During a routine exam, Livingston's doctor found a lump in the remaining right side of her thyroid gland.  As before, a biopsy was done, but the results were inconclusive.  She had two alternatives, watchful waiting or removal of the remainder of her thyroid. 

"I'm very proactive, so at that point, just knowing there was something there, whether it was cancer or not, I wanted it removed," said Livingston.

Because she had had surgery in the same area eight years earlier, Livingston was especially worried about the scar. 

Dr. Ho-Sheng Lin, a specialist in head and neck cancers at the Barbara Ann Karmanos Cancer Institute, offered her an alternative.  Lin said very little had changed about thyroid surgery in decades until recently.  With the newest procedure, the goal is to avoid any scar in the neck.

Lin offered Livingston a procedure that allows surgeons to operate on the thyroid gland through a path under the skin that starts in the armpit.  Because the pathway surgeons work through is so narrow, the operation is done using the daVinci robotic surgical system. 

"I was pretty awestruck by the possibility of a robot just being part of this whole surgical procedure," said Livingston.

The procedure is technically more complex than the traditional surgery, so it's not ideal for everyone.

"The patient who would benefit the most is the patients who we really don't know if it's cancer or not, but we just need to rule it out," said Lin.

Thinner patients and people with darker skin, who form darker scars or even keloids, are also better candidates for the surgery. 

Dr. Lin removed the remainder of Michelle's thyroid through an incision in her right armpit. Going into the procedure, no one knew if the lump contained cancer.  After the remainder of her thyroid was removed, careful examination under a microscope found there was a small area that contained cancer. 

"When the surgery was over, the thyroid was gone as well as the cancer.  I kind of look at it like cancer kissed me hello and goodbye in the same day," said Livingston.

To visit the Barbara Ann Karmanos Cancer Institute's website, click here