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. 2018 Apr-Jun;14(2):118-123.
doi: 10.4103/jmas.JMAS_3_17.

Transoral endoscopic total thyroidectomy vestibular approach: A case series and literature review

T Sivakumar  1 , R A Amizhthu  1
Affiliations

Transoral endoscopic total thyroidectomy vestibular approach: A case series and literature review

T Sivakumar et al. J Minim Access Surg. 2018 Apr-Jun.

Abstract

Conventional open thyroidectomy is often associated with post-operative complications including nerve damage, voice disturbances, paraesthesias, adhesions and prominent scarring. Several endoscopic surgical techniques have been reported as alternatives to conventional thyroidectomy. Natural orifice transluminal endoscopic surgery is a promising approach which leaves no scar, produces few complications and affords faster discharge from care. Several studies have explored its utility in total thyroidectomy in patients with benign or malignant thyroid disease. Herein, we present a case series on the successful application of transoral endoscopic total thyroidectomy vestibular approach (TOETVA) in benign and malignant diseases of the thyroid. We performed TOETVA in 11 patients presenting with benign or malignant thyroid nodules in our hospital, between 1st January 2015 and 30th June 2016. The surgery was completed successfully in all patients with a pre-operative diagnosis of multinodular goitre. The surgery was performed under general anaesthesia and the mean operative time was 130 min. The mean blood loss was 2-3 cc. No incidence of recurrent laryngeal nerve injury, damage to mental nerve, parathyroid damage or peri-incisional adhesion occurred in the study participants. No visible scarring occurred in the patients following surgery. The patients had an uneventful recovery after the surgery and were discharged after 4 days. TOETVA is safe and effective in the surgical management of multinodular goitre and offers a scar-free alternative to conventional surgery.

Keywords: Multinodular goitre; thyroidectomy; transoral endoscopic total thyroidectomy.

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Conflict of interest statement

There are no conflicts of interest

Figures

Figure 1
Figure 1
Position of surgeons and assistants during surgery. Surgeon stands at head end, camera surgeon stands left to the surgeon and second assistant stands right side to the surgeon
Figure 2
Figure 2
The patients were placed in supine position for the surgery, with the use of a pillow support below the shoulder and head ring to maintain neck extension
Figure 3
Figure 3
Position of ports
Figure 4
Figure 4
Removal of the specimen using endobag
See this image and copyright information in PMC

References

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