Transoral endoscopic thyroidectomy using vestibular approach: A single center experience.

Area of Science:

• Endocrinology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Thyroidectomy often leaves visible scars, impacting patient aesthetics.
• Natural Orifice Transluminal Endoscopic Surgery (NOTES) presents a scarless alternative.
• The transoral vestibular approach is an emerging technique for endoscopic thyroidectomy.

Purpose of the Study:

• To present the initial experience with transoral endoscopic thyroidectomy using a vestibular approach.
• To evaluate the safety, feasibility, and outcomes of this scar-free thyroidectomy technique.

Main Methods:

• A three-port technique was employed via the oral vestibule (one 10 mm, two 5 mm ports).
• CO2 insufflation at 12 mm Hg was used.
• Anterior cervical subplatysmal space was created for dissection and thyroid removal using laparoscopic instruments and a harmonic scalpel.

Main Results:

• Ten procedures were performed between May 2016 and December 2017.
• Procedures included hemi-thyroidectomy for solitary nodules and total/near-total thyroidectomy for multinodular goiter.
• No major complications (vocal cord paralysis, hypoparathyroidism, etc.) were observed; two minor hematomas occurred.

Conclusions:

• Transoral endoscopic thyroidectomy is a safe and feasible minimally invasive surgical option.
• The vestibular approach yields excellent cosmetic results.
• This technique represents a significant advancement in scarless thyroid surgery.