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Transoral endoscopic thyroidectomy: preliminary experience in Italy
Gianlorenzo Dionigi1, Alessandro Bacuzzi2, Matteo Lavazza3
11st Division of Surgery, Department of Medicine and Surgery, Endocrine Surgery Research Center, University of Insubria, Varese, Italy. gianlorenzo.dionigi@uninsubria.it.
Updates in Surgery
|April 14, 2017
Summary
Transoral endoscopic thyroidectomy vestibular approach (TOETVA) offers a scarless surgical option for thyroid conditions. This initial Italian experience shows TOETVA is feasible, safe, and achieves excellent cosmetic results with minimal complications.
Area of Science:
- Endocrinology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is an emerging technique for thyroid surgery.
- It aims to provide a scarless surgical option, improving cosmetic outcomes.
- This study reports the initial experience with TOETVA in Italy.
Purpose of the Study:
- To evaluate the feasibility, safety, and outcomes of the transoral endoscopic thyroidectomy vestibular approach (TOETVA).
- To assess the cosmetic results and complication rates of TOETVA.
- To document the initial experience of TOETVA in an Italian patient cohort.
Main Methods:
- A prospective case series of 15 patients undergoing TOETVA.
- Inclusion criteria included specific thyroid nodule/gland size and benign or early-stage malignant diagnoses.
- The procedure utilized a three-port endoscopic technique via the oral vestibule with CO2 insufflation and intraoperative neuromonitoring.
Main Results:
- All 15 TOETVA procedures were completed successfully without conversion to open surgery.
- Mean operative times were 87.6 minutes for hemithyroidectomy and 107.6 minutes for total thyroidectomy.
- One case of transient hypocalcemia occurred; no recurrent laryngeal nerve palsy was observed, and cosmetic results were excellent.
Conclusions:
- TOETVA is a feasible and safe endoscopic surgical approach for selected thyroid conditions.
- The technique yields excellent cosmetic results with a low complication rate.
- This initial Italian experience suggests promising potential for wider TOETVA application.