Subcutaneous Endoscopy

Operating on the Back, Chest, Neck, Head and Sides without Leaving Noticeable Scars

Access through the Armpit: Subcutaneous Endoscopy
Our pediatric general surgery team performs subcutaneous endoscopy to remove lesions and masses on a child’s sides, back, chest, neck or head without leaving noticeable scars.

How the procedure is done. Pediatric general surgeons insert tiny, flexible surgical instruments into a few small openings in the armpit. Those instruments are maneuvered under the skin up to the surgical site. This layer of the skin is loose tissue, so the instruments do not cause any damage. Once the procedure is completed, the patient is left with small scars in the armpit that remain well-hidden.

Some of the conditions that can be treated by this technique include:

• Thyroid conditions – thyroid lobectomy (removal)
  Parathyroid adenomas and other parathyroid conditions – parathyroid lobectomy (removal)
• Removal of lesions on the face and neck
  • Enlarged cervical lymph node
  • Thyroglossal duct cyst
  • Dermoid cyst
• Torticollis

Stanford’s First Endoscopic Thyroid Lobectomy
In 2010, Drs. Marilyn Butler, Sanjeev Dutta and Gary Hartman performed the first endoscopic thyroid lobectomy at Lucile Packard Children's Hospital and Stanford Hospital & Clinics. The surgeons removed a portion of a 5 year old child’s thyroid gland. They created three incisions in the child’s armpit, each of which were 5 mm – the width of a pencil. Endoscopic instruments were inserted under the child’s skin, slid over the collarbone, and into the neck area. The child:

• Did not lose any blood during the procedure
• Returned to normal activities very quickly
• Did not have a scar running across his neck