Background: Endoscopic thyroidectomy has increased in popularity because of the good cosmesis. In Thailand, most
endoscopic thyroidectomy surgeries are done with a gas technique, using CO2 insufflation to obtain a working space. The CO2 pressure has to be kept under control to prevent gas-related complications. In contrast, there are no such complications in video assisted neck surgery (VANS), a gasless technique. The VANS technique could be an option of endoscopic thyroidectomy in Thailand.
Objective: This study reports the outcome of the initial experience of using gasless endoscopic thyroidectomy (VANS technique) in Thailand.
Material and Method: From July to October 2015, five patients underwent thyroidectomy with the VANS technique at Thammasat University Hospital. Patient selection criteria consisted of non-malignant nodule diagnosed by FNA, nodule size <4 cm, no previous neck surgery and no neck irradiation.
Results: All five patients successfully underwent endoscopic thyroid lobectomy with the VANS technique. The mean operating time was 152 minutes and mean blood loss was 34 ml. There were no serious complications, and the patients were satisfied with the cosmetic outcomes. Pathologic results were nodular goiter in four cases and adenomatous goiter with occult papillary microcarcinoma in one case (in this case, the margins were free of malignancy).
Conclusion: The VANS technique is feasible and safe to be used in Thailand.

Keywords: Gasless endoscopic thyroidectomy, VANS