{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T06:03:40Z","timestamp":1779775420317,"version":"3.53.1"},"reference-count":6,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:00Z","timestamp":1752537600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Minimally invasive thyroidectomy has evolved to improve cosmetic outcomes while maintaining surgical safety. The axillo-breast approach is increasingly favored, yet standardized methods to enhance anatomical clarity and nerve preservation are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To describe the Axillo-Breast Lateral Entry (ABLE) technique for endoscopic hemithyroidectomy and introduce the Critical Landmark Exposure &amp; Anatomical Recognition (CLEAR) concept for safer dissection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>A retrospective review was conducted on 40 patients who underwent ABLE endoscopic hemithyroidectomy without intraoperative neuromonitoring between January 2023 and October 2025 at a tertiary centre in Northern India. Standard laparoscopic instruments and energy devices were used. Port placements followed ergonomic principles. The CLEAR view was applied to reliably identify key structures: recurrent laryngeal nerve (RLN), inferior thyroid artery (ITA), and parathyroid glands within a defined anatomical triangle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>All patients had benign nodules with a mean size of 4.4 \u00b1 1.2 cm. The RLN was visually identified in 100% of cases. There were no instances of permanent vocal cord palsy or hypoparathyroidism. All patients were discharged by postoperative day one, with excellent cosmetic outcomes and no major complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The ABLE technique is safe, reproducible, and ergonomically favorable, particularly for early-career surgeons. The CLEAR concept provides a consistent anatomical framework for preserving critical structures, especially when intraoperative neuromonitoring is not available. This approach may facilitate wider adoption of endoscopic thyroidectomy in resource-limited settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10926429251359746","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T18:27:57Z","timestamp":1757960877000},"page":"753-757","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Critical Landmark Exposure &amp; Anatomical Recognition and Axillo-Breast Lateral Entry: Endoscopic Thyroidectomy"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5212-4203","authenticated-orcid":false,"given":"Kushagra","family":"Gaurav","sequence":"first","affiliation":[{"name":"Department of General Surgery, King George\u2019s Medical University, Lucknow, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8715-4568","authenticated-orcid":false,"given":"Akshay","family":"Anand","sequence":"additional","affiliation":[{"name":"Department of General Surgery, King George\u2019s Medical University, Lucknow, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4935-7145","authenticated-orcid":false,"given":"Ranjith Kumaran","family":"R","sequence":"additional","affiliation":[{"name":"Department of General Surgery, King George\u2019s Medical University, Lucknow, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5093-1992","authenticated-orcid":false,"given":"Abhinav Arun","family":"Sonkar","sequence":"additional","affiliation":[{"name":"Department of General Surgery, King George\u2019s Medical University, Lucknow, India."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,15]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00129689-200002000-00001"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2010.02.053"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.4240\/wjgs.v11.i2.62"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.5005\/jp-journals-10002-1136"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.5005\/jp-journals-10002-1286"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.14740\/jocmr4296"}],"container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10926429251359746","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10926429251359746","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10926429251359746","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T05:27:43Z","timestamp":1779773263000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10926429251359746"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,15]]},"references-count":6,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9,1]]}},"alternative-id":["10.1177\/10926429251359746"],"URL":"https:\/\/doi.org\/10.1177\/10926429251359746","relation":{},"ISSN":["1092-6429","1557-9034"],"issn-type":[{"value":"1092-6429","type":"print"},{"value":"1557-9034","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,15]]}}}