The ima approach for the quick identification of the right recurrent laryngeal nerve in thyroid cancer surgery.
ABSTRACT BACKGROUND: The right recurrent laryngeal nerve (RLN) is more difficult to identify than the left RLN. The superior, lateral and inferior approaches are currently used to identify the RLN. This report presents a new technique, called the ima approach (the most inferior approach) for the quick identification of the right RLN. METHODS: The ima approach involves dissection along the right common carotid artery and division of the most lateral branch of the inferior thyroid veins. The right RLN is identified at the bottom of the RLN triangle. This technique and the conventional inferior approach were applied to 81 and 19 patients with thyroid cancer, respectively. RESULTS: The ima approach required a significantly shorter time in identifying the nerve than the inferior approach (9.6 ± 16.6 and 31.2 ± 24.4 s, respectively, p < 0.0001). CONCLUSION: The ima approach is an easy, quick and safe technique for identifying the right RLN.