Over the last decades, surgeons have been in pursuit of alternative options using remote-access incisions to render thyroidectomy more cosmetically acceptable. However, Remote-access thyroidectomy has been faced with many challenges, including patient selection, geographical variations, financial hurdles, learning curves, and most recently, competition from a new, less invasive treatment modality, thermal ablation. We made the position statement to describe the different techniques, patient selection criteria, and outcomes determined by an international consensus panel, including six international societies, regarding the current value of remote-access thyroid surgery.

In conclusion, remote access thyroid and parathyroid surgery is a safe alternative for a majority of patients who require thyroid or parathyroid surgery when completed by experienced surgeons. Major complication rates are similar, oncologic outcomes are not inferior, and quality of life measures, including swallowing and voice measures, are not inferior. Cosmesis and scar-related quality of life measures remain superior across time. While overall quality of life appears slightly better with remote access techniques, unique complications have been described and should be balanced with patient objectives. To achieve optimal outcomes, appropriate training and preparation are required.

Because remote access approaches are options for a majority of patients, it becomes incumbent on surgeons and referring doctors to be familiar with the various treatment options and discuss these approaches with a majority of patients. Centers of excellence where these techniques are routinely offered may encourage optimal outcomes.