Inclusion Criteria:  Patients undergoing thyroid surgery for the first time The surgical method is TOETVA There is no lateral cervical lymph node metastasis assessed before surgery Fine-needle aspiration revealed palpilary thyroid carcinoma It meets the surgical indications and has no obvious surgical contraindications  Exclusion Criteria:  previous history of thyroid surgery; conventional open thyroidectomy, endoscopic thyroidectomy areola approach or axillary approach; patients undergoing cervical lateral lymph node dissection; past or current history of hyperthyroidism; history of combined hypertension, diabetes, coagulation dysfunction, or other important organ dysfunction diseases.