“Stealth” retro-auricular endoscopic surgery for a submandibular mass

•Laparoscopic stealth approach for tumor in submandibular region.•Retro-auricular hairline totally endoscopic procedure.•Dissection using baloon spacer.•Feasibility with superior cosmetic results (scareless).•First ever reported case in the gulf countries. With the need for increased cosmesis, it is the desire of patients all over the world to avoid an unsightly scar over the neck, face, or any of the exposed areas. This popularised the concept of “stealth” surgery. A 42 year-old gentleman underwent a stealth surgery for a painless progressively growing mass in the left submandibular triangle, which was provisionally diagnosed as a Lymphoma. As he desired a scarless procedure, a linear incision in the neck was avoided, and the surgical team opted for a Retro-Auricular HairLine (RAHL) approach, with a combination of balloon spacing and ultrasonic shears dissection. The procedure was performed with perfect hemostasis, and is being reported as the first case of stealth RAHL (scarless) surgery in the United Arab Emirates for a submandibular mass. This article has been reported in line with the SCARE criteria [1]. “Stealth” surgery is becoming increasingly popular as it helps to avoid unsightly incisions in exposed areas of the body. The term was first used by by the paediatric surgical department of John Hopkins hospital, and it caught the fancy of the public as well as the surgeons. A retro-auricular endoscopic excision of a submandibular mass is being reported in this article for its feasibility and cosmesis. Following the principles of “stealth” surgery, invisible port site incisions were used to complete the surgery successfully. The purpose of this case report was to illustrate the feasibility and safety of the endoscopic resection using the retro-auricular approach for submandibular mass excision.