A 30-degree 5mm endoscope is inserted Ganetespib side effects through the skin incision. 4.2. Anterior Chest Wall ApproachGasless ET can be provided for the treatment of differentiated thyroid cancer. This approach using a modified flap-lifting device was first introduced by Kim et al. [29] and subclavicular approach shows less trauma than other SET approaches. The main procedure can be listed as follows [30]. A 3cm oblique skin incision is made in a midclavicular line on the anterior chest wall. The working space is dissected underneath the platysma muscle, advancing from the incision to the thyroid area and across the medial border of the sternocleidomastoid muscle. A 5mm trocar is inserted lateral to the skin incision. The margins of the incised opening are covered with a silastic material.

A 30-degree 5mm endoscope is inserted through the 5mm port. TET can also be used for radical differentiated thyroid cancer. The procedure begins with a 1cm long incision one-fourth the distance from the xiphoid to the sterna notch. A separating stick is used to perform a dissection of the subcutis and then make the insertion of a 10mm trocar. 6�C8mmHg gas pressure CO2 insufflation is used to maintain working space. A 10mm 30-degree endoscope is then inserted. After bilateral transversal incisions have been created one-third the distance from the nipple to the sternoclavicular joint, 5mm and 10mm trocars are inserted [31].4.3. Breast ApproachThe first case of this procedure is famous in China [32]. The main target is to avoid the scar in the neck. The brief procedure is described as follows [33].

The camera port over 1.5�C2.0cm is placed over the right parasternal Brefeldin_A region. A subcutaneous tunnel is created by using blunt dissection. Insufflation of CO2 is used to create working space. Two additional skin incisions are made at the upper margin of mammary areolae, followed by the insertion of one 5mm trocar and another 10mm trocar.4.4. Axilla ApproachIt is also an aim to achieve an optimal cosmetic result for axilla approach for thyroidectomy. The operative technique is performed as follows [34]. Raise the lesion-side arm to expose the axillary fossa. Make a 5-6cm skin incision in the axillary fossa and elevated the skin flap under direct vision in the plane of the subplatysmal layer over the pectoralis major muscle from the axilla to the anterior central neck area. Dissect through the space between the sternal and clavicular head of the sternocleidomastoid muscle. Then dissect underneath the sternothyroid muscle to expose the thyroid gland. An external retractor is used to maintain working space.4.5. Axilla-Breast ApproachAxilla-breast approach was first reported in 2007 [35].