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Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
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Transoral thyroid surgery vestibular approach: does size matter anymore?
E Karakas1,2, G Klein3, S Schopf4
1Department of General, Abdominal and Endocrine Surgery, Hospital Maria Hilf, Alexianer GmbH, 47805, Krefeld, Germany. e.karakas@alexianer.de.
Journal of Endocrinological Investigation
|January 29, 2020
Summary
Transoral endoscopic thyroid surgery, combining TOETVA and EndoCATS (TOVARA), offers a scarless solution for larger thyroid glands. This approach is safe and feasible in Western Europe, expanding minimally invasive options.
Area of Science:
- Endocrinology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Minimally invasive thyroid surgery aims to reduce visible neck scarring.
- The transoral endoscopic thyroidectomy vestibular approach (TOETVA) is suitable for small thyroid specimens.
- Combining TOETVA with retroauricular endoscopic cephalic access thyroid surgery (EndoCATS) expands transoral surgery indications.
Purpose of the Study:
- To evaluate the feasibility and safety of combining TOETVA and EndoCATS (TOVARA) for thyroid surgery.
- To optimize specimen extraction and enable transoral surgery for larger thyroid glands.
- To broaden the application of scarless transoral thyroid surgery.
Main Methods:
- Retrospective evaluation of transoral thyroidectomy techniques in Germany and Austria since 2017.
- Combination of TOETVA with EndoCATS (TOVARA) for specimen removal.
- Assessment of patient characteristics, surgical outcomes, and complications.
Main Results:
- 71 procedures in 70 patients; 60 TOETVA, 10 TOVARA.
- Median operation time 205 minutes; 1% permanent recurrent laryngeal nerve injury rate.
- No conversions to open surgery; two cases of long-term mental nerve injury; no infections.
Conclusions:
- Transoral endoscopic thyroid and parathyroid surgery via the vestibular approach is feasible and safe in Western Europe.
- The TOVARA technique allows scarless thyroid surgery for specimens exceeding 40 ml.
- This combined approach expands the possibilities for aesthetic outcomes in thyroid surgery.
