[Transoral endoscopic thyroidectomy. Part 1: rationale and anatomical studies]

Area of Science:

• Surgical innovation in head and neck procedures.
• Anatomical studies for surgical access.
• Minimally invasive surgical techniques.

Context:

• Traditional thyroidectomy techniques can cause significant surgical trauma.
• Extracervical approaches, while hiding incisions, involve extensive dissection, negating minimally invasive benefits.
• Need for a gentler surgical access for thyroidectomy.

Purpose:

• To develop a non-traumatic, endoscopic minimally invasive thyroidectomy approach.
• To reduce surgical access trauma by utilizing anatomical planes.
• To establish the transoral approach for thyroid surgery.

Summary:

• Anatomical dissections on cadavers and surgical specimens identified safe access routes via the mouth.
• The transoral approach allows trocar placement in the sublingual and oral vestibule regions.
• This facilitates direct access to an avascular subplatysmal area and the pretracheal space for endoscopic thyroidectomy.

Impact:

• Establishes the foundation for a novel natural orifice surgery (NOS) procedure for thyroidectomy.
• Demonstrates the potential for minimum impact and gentle dissection.
• Offers a promising alternative to conventional thyroidectomy with reduced access trauma.