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Transoral periosteal thyroidectomy: cadaver to human
Hye Yoon Lee1, Ji Young You, Sang Uk Woo
1Department of Surgery, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 136-705, Korea.
Surgical Endoscopy
|August 16, 2014
Summary
Transoral periosteal thyroidectomy (TOPOT) offers an improved surgical view and motion for robotic thyroid surgery. This novel technique demonstrated safety and effectiveness in initial human trials, with temporary mental nerve paresthesia as the main complication.
Area of Science:
- Minimally Invasive Surgery
- Endocrine Surgery
- Robotic Surgery
Background:
- Existing endoscopic thyroidectomy methods face challenges with flap dissection and prolonged surgical times.
- Transoral endoscopic thyroidectomy represents an advancement, overcoming limitations of prior approaches.
- Transoral periosteal thyroidectomy (TOPOT) was developed to further enhance endoscopic thyroid surgery.
Purpose of the Study:
- To evaluate the initial experience and feasibility of transoral periosteal thyroidectomy (TOPOT).
- To assess the safety and efficacy of robotic TOPOT in human subjects.
- To compare TOPOT with existing endoscopic thyroidectomy techniques.
Main Methods:
- TOPOT was initially performed in seven human cadavers and ten pigs to optimize the technique.
- Robotic TOPOT was subsequently performed in four human patients using the da Vinci® surgical system.
- Outcomes assessed included recurrent laryngeal nerve function, complications, and postoperative results.
Main Results:
- Robotic TOPOT was successfully used for lobectomies and a central neck dissection in human patients.
- Temporary mental nerve paresthesia occurred in three patients, resolving within four weeks.
- No local infections or recurrent laryngeal nerve palsies were observed postoperatively.
Conclusions:
- Transoral periosteal thyroidectomy (TOPOT) shows promise as an effective and safe method for robotic thyroid surgery.
- The technique offers improved visualization and maneuverability compared to previous endoscopic approaches.
- Further studies are warranted to establish TOPOT's long-term efficacy and broader applicability.
