Novel Approach to Removing Thyroid and Parathyroid Glands Prevents a Visible Scar A surgical team from the University of Chicago Medicine led by Raymon Grogan, MD, assistant professor of surgery, and Zhen Gooi, MD, assistant professor of surgery, was the first in the Midwest and the fourth in the United States to remove diseased thyroid or parathyroid glands—located at the front of the neck, an inch or two below the chin—using an approach that leaves no visible scar. The standard thyroid operation has long been performed through a two-inch or longer opening in the neck, known as a transverse-collar incision. This leaves a permanent, obvious scar. The new trans-oral approach, developed by a sur- geon in Bangkok, Thailand, was designed to hide the scar. Instead, surgeons make the incision inside the mouth, at the crease between the gums and the lower lip. “No one but your dentist will see this, and most dentists will not notice,” said Grogran, who directs the endocrine surgery research program at the University of Chicago. “Once the incisions have healed, patients cannot see them.” The surgeon makes three small incisions in the space where the inside of the lower lip meets the gums. The biggest is 10 millime­ - ters long (less than half an inch), to accommodate a light and a min- iature video camera. They then tunnel beneath the skin until they reach the thyroid. “From that point on, this is the same anatomy that you see during an open thyroid operation,” Grogan said. “It allows for excellent visualization, maybe better than the open approach, and provides a lot of mobility for the instruments.” Post–operation photos of Sheri Caine, a high school physics teacher from Oak Forest, IL, who had undergone the new “scarless” surgical technique for her small thyroid cancer. “No one but your dentist will see this, and most dentists will not notice. Once the incisions have healed, patients cannot see them.” — Raymon Grogan, MD 19