Thyroidectomy: a novel endoscopic oral vestibular approach

Area of Science:

• Minimally Invasive Surgery
• Endocrine Surgery
• Surgical Oncology

Background:

• Endoscopic thyroidectomy offers cosmetic advantages over open surgery.
• The oral vestibular approach (ETOVA) for endoscopic thyroidectomy has not been previously reported.
• Evaluating ETOVA's feasibility, safety, efficacy, and cosmetic outcomes is crucial.

Purpose of the Study:

• To assess the feasibility, safety, efficacy, and cosmetic results of endoscopic thyroidectomy via the oral vestibular approach (ETOVA).
• To compare ETOVA with the endoscopic thyroidectomy by areola approach (ETAA).

Main Methods:

• A randomized controlled trial comparing ETOVA (n=12) and ETAA (n=12) for benign thyroid nodules.
• Patients were followed for physical examination, thyroid function, and scar assessment.
• Surgical outcomes including time, blood loss, hospital stay, and cost were recorded.

Main Results:

• Complete endoscopic resection was achieved in all patients, with no open conversions.
• No significant differences were observed in surgical time, blood loss, hospital stay, or cost between ETOVA and ETAA.
• ETOVA resulted in no visible scars, while ETAA left three visible scars. Patient satisfaction was significantly higher in the ETOVA group (P = .019).
• No severe complications like nerve injury or parathyroid dysfunction were reported.

Conclusions:

• Endoscopic thyroidectomy using the oral vestibular approach (ETOVA) is a safe and feasible technique.
• ETOVA offers superior cosmetic results with no visible scarring compared to the areola approach.
• Larger randomized clinical trials are warranted to validate these findings for scarless thyroid surgery.