Transoral endoscopic thyroidectomy vestibular approach (TOETVA): A case report as new technique in thyroid surgery in...

Transoral endoscopic thyroidectomy via vestibular approach (TOETVA) is a promising procedure with many advantages such as truly scar free healing, minimally invasive dissection, and accessible approach to both thyroid lobes.

A female patient aged 19 presented with a benign thyroid nodule 2 cm in size for a year and the patient decided to proceed with surgery. The operation with a left subtotal thyroidectomy performed by the TOETVA technique was indicated. The surgery was implemented in 110 min, the patient was discharged after three days of postoperative care without any complication except for a mild seroma and swelling in the anterior neck which resolved completely within 10 days.

Endoscopic thyroidectomy is a favorable approach to treat patients with benign nodules, Grave's disease and thyroid cancer which has 1-2 cm cancer nodule without extrathyroid extension. There are direct (cervical-anterior or lateral) and extracervical endoscopic procedures to have the thyroid exposed but multiple small scars remain. However, TOETVA is an excellent choice for select patients requiring thyroid surgery who desire to avoid a neck incision.

TOETVA with the potential for scar-free surgery is a safe and effective procedure which provides good cosmetic outcome. The long operative time of this approach will be shortened with experience.