Completion thyroidectomy via the transoral endoscopic vestibular approach

Area of Science:

• Endocrinology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is an emerging technique for thyroid surgery.
• Initial applications focused on benign thyroid conditions, but indications have expanded to include select well-differentiated thyroid cancers (DTCs).
• The oncologic efficacy and established management pathways following TOETVA for DTCs are still under investigation.

Observation:

• A case involving a diagnostic thyroid lobectomy using the TOETVA technique was performed.
• The patient subsequently underwent a completion thyroidectomy via the same TOETVA approach for minimally invasive Hurthle cell carcinoma.
• Post-operative assessment confirmed no residual thyroid tissue and undetectable serum thyroglobulin levels.

Findings:

• The TOETVA approach facilitated both initial diagnostic lobectomy and subsequent completion thyroidectomy in a patient with Hurthle cell carcinoma.
• Successful completion thyroidectomy via TOETVA resulted in no evidence of thyroid remnant on ultrasound.
• Post-operative serum thyroglobulin levels were significantly suppressed, indicating successful disease management.

Implications:

• This case demonstrates the feasibility of using TOETVA for a two-stage surgical management of select thyroid cancers.
• The findings support TOETVA as a viable option for completion thyroidectomy following an initial diagnostic lobectomy.
• Further research is warranted to establish long-term oncologic outcomes and refine guidelines for TOETVA in thyroid cancer treatment.