Pneumoperitoneum after transoral endoscopic thyroidectomy vestibular approach

Area of Science:

• Surgical Innovation
• Minimally Invasive Surgery
• Endocrine Surgery

Background:

• Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is a safe endoscopic procedure.
• Known complications include subcutaneous emphysema and pneumomediastinum.
• Pneumoperitoneum has not been previously reported after TOETVA.

Purpose of the Study:

• To report the first case of pneumoperitoneum following TOETVA.
• To raise awareness among surgeons about this potential complication.

Main Methods:

• A patient underwent a successful transoral endoscopic thyroidectomy vestibular approach (TOETVA).
• Postoperative imaging (CT scan) confirmed subcutaneous emphysema, pneumomediastinum, and pneumoperitoneum.
• The patient was managed conservatively.

Main Results:

• The patient experienced subcutaneous emphysema, pneumomediastinum, and pneumoperitoneum post-TOETVA.
• Conservative management led to an uneventful recovery.
• This represents the first documented instance of pneumoperitoneum after TOETVA.

Conclusions:

• Pneumoperitoneum is a potential, albeit rare, complication of TOETVA.
• Surgeons should consider pneumoperitoneum in the differential diagnosis for postoperative symptoms after TOETVA.
• Awareness and exclusion of other causes are crucial for appropriate patient management.