手术要点：采用胸乳入路，直视下用超声刀在颈阔肌深面建立空间，两侧达胸锁乳突肌外缘，上界达甲状软骨上缘；使用超声刀纵向切开颈白线，在真、假被膜之间疏松间隙内分离甲状腺前方、下极和外侧面，使用腔镜拉钩拉开颈前肌群来扩大手术操作的空间，充分暴露甲状腺分离气管前间隙，靠健侧离断峡部，沿甲状腺被膜精细化解剖游离患侧腺叶，避免损伤甲状旁腺；应用神经探测四步法寻找并监测喉返神经信号；保持超声刀工作刀头距神经>3 mm，将患侧腺叶完整游离；夹闭并切断甲状腺上动脉，防止迟发出血；标本袋取出标本送检。可吸收线缝合颈前带状肌，留置引流管。

The main points of surgical procedures were as follows: thyroidectomy were performed via an Chest-breast approach. Under the direct view, ultrasonic scalpel was used to establish subcutaneous surgical space below the jugular broad muscle, with outer edge of the sternoclavus muscle on both sides and upper edge of thyroid cartilage. Cervical linea alba was dissected by using ultrasonic scalpel. The front, lower and outer sides of the thyroid gland were separated through loose space between dorsal membrane of thyroid. The anterior cervical muscle groups were pulled by using endoscopic hook to expand surgical space. To fully expose and to separate anterior trachea space, then to cut off isthmus. Thyroid lobes were exposed by delicate dissection along the thyroid membrane to avoid damage to the parathyroid gland. Four steps of neural detection were used to search and monitor the recurrent laryngeal nerve signal. Make sure a 3 mm distance between surgical plane and nerve when using ultrasonic scalpel. After the lobe dissociate completely, the superior thyroid artery were cliped and cutted off, to prevent late bleeding. The resected specimens were taken out for pathological examination by using specimen bag. The anterior cervical muscle groups was sutured with absorbable lines . Finally, drainage tube was placed.