Description: This session will explore the latest advances in thyroid surgery, with a focus on how innovation is reshaping clinical practice. From refined surgical techniques to emerging paradigms in surveillance and molecular diagnostics, the session will address how evidence-based strategies are driving more personalized, safer, and effective thyroid cancer management. Topics will include novel nerve-sparing approaches, advances in intraoperative neuromonitoring, and the expanding role of active surveillance for low-risk papillary thyroid carcinoma. Furthermore, the session will delve into the use of circulating tumor DNA (ctDNA) for postoperative monitoring and disease recurrence detection. Expert speakers will present recent data, discuss controversies in patient selection, and share practical approaches to integrating new techniques into surgical workflows.

Outcome Objectives:

1. Describe current innovations in thyroid surgery, including nerve-sparing and minimally invasive techniques.

2. Evaluate the role and criteria for active surveillance in low-risk thyroid cancer.

3. Understand the clinical application and limitations of ctDNA in postoperative monitoring and long-term follow-up.

4. Discuss the implications of molecular and imaging advances on surgical decision-making and patient outcomes.

5. Integrate updated strategies for recurrent laryngeal nerve preservation using intraoperative neuromonitoring and mapping.

Background: Thyroid surgery is undergoing a period of rapid transformation. While the incidence of thyroid cancer has increased, many cases—particularly small, low-risk papillary thyroid carcinomas—exhibit indolent behavior, prompting a reevaluation of the traditional surgical approach. Active surveillance, once considered controversial, is now supported by robust evidence demonstrating its safety in selected patients. Concurrently, innovations in intraoperative technology, such as continuous nerve monitoring and advanced mapping systems, have significantly improved the ability to preserve the recurrent laryngeal nerve, reducing postoperative complications and improving quality of life.

Minimally invasive and remote access techniques, including transoral endoscopic thyroidectomy vestibular approach (TOETVA), are also gaining traction, offering better cosmetic outcomes without compromising safety. Beyond surgical technique, molecular diagnostics are playing an increasing role in both preoperative risk stratification and postoperative surveillance. ctDNA analysis is emerging as a promising biomarker for detecting minimal residual disease and early recurrence, potentially transforming long-term management and follow-up protocols.

This session is designed for endocrine surgeons, oncologists, and endocrinologists interested in cutting-edge, multidisciplinary approaches to thyroid cancer care. Attendees will gain insights into the evidence, tools, and practical strategies necessary to apply these advances in clinical practice and contribute to the ongoing evolution of thyroid surgery.