In recent years, endoscopic thyroid surgery has been developed and refined, with the direction of better aesthetic results, as well as minimal trauma and lower complication rates, based on safety and feasibility. For this reason, scholars from various countries have explored various endoscopic thyroid surgery pathways, such as axillary pathway, double areola pathway thyroid surgery, double areola unilateral axillary pathway thyroid surgery, double axillary unilateral areola pathway, double axillary double areola pathway thyroid surgery, single-port thyroid surgery and transoral endoscopic thyroid surgery. The unilateral axillary pathway is more invasive, relatively difficult to operate, and can only deal with one side of the lesion, which limits its application and promotion. The areola or axillary pathway is easy to operate and can deal with bilateral lesions, so it is easy to promote and be mastered by surgeons, but the mammary gland is an important female sexual organ, and patients are often reluctant to operate on the mammary gland and have scars, and the areola pathway leaves a small surgical scar on the anterior chest wall and even forms scars, which affects cosmetology and brings patients discomfort such as hidden pain and itching, resulting in postoperative patient satisfaction. This results in lower patient satisfaction after surgery. Therefore, we need to explore a better surgical method. For this reason, based on years of endoscopic areolar pathway thyroid surgery, we have explored endoscopic bilateral axillary pathway thyroid surgery. It is also the latest surgical approach. Post-operative surgical incision Post-operative surgical incision