We have developed an original technique for performing endoscopic thyroidectomy using a breast approach with CO2 insufflation (6 mm Hg) since 1997, which results in no operative scar in the neck. Five hemi-thyroidectomies for thyroid adenomas and one subtotal thyroidectomy for Graves' disease have been successfully performed using this procedure, and the results of cosmemis were very satisfactory for all patients.