Abstract: Objective    To investigate the efficacy of applying the three-step method of full laryngeal recurrent nerve visualization to prevent laryngeal recurrent nerve injury during laparoscopic thyroidectomy via anterior chest approach.   Methods  The 78 surgical videos performed by the author's surgical team, from July 2021 to July 2023, as well as clinical data of the patients were retrospectively analyzed to observe intraoperative full laryngeal recurrent nerve visualization and postoperative occurrence of nerve injury symptoms or other adverse reactions.  Results   All the 78 surgical operations were successfully completed without intermediate open surgery, and altogether 117 recurrent laryngeal nerves were exposed throughout the operation, with intraoperative bleeding of 20-100 mL (average 37.8 mL). No symptoms of recurrent laryngeal nerve damage, such as hoarseness of voice or dysphagia, were observed in all 78 patients after the operation.  Conclusions   The three-step method of full laryngeal recurrent nerve visualization in laparoscopic thyroidectomy via anterior chest approach  contributes to the protection of the functional integrity of the recurrent laryngeal nerve and reduces the recurrent laryngeal nerve injury by latent heat, and this method can be operated conveniently with easy learning, which is worth to be popularized in the clinic.

Key words: Laparoscope; ,  , Thyroid; ,  , Recurrent laryngeal nerve; ,  , Endoscopic thyroidectomy