Lateral Vestibular Approach to the Central Neck for Thyroid and Parathyroid Surgery: A Cadaveric Study

The transoral endoscopic approach to the central neck has rapidly become one of the most widely utilized remote-access approaches for thyroid and parathyroid surgery in the world. The approach involves three small incisions inside the lower lip and has an optimal cosmetic outcome with no visible scar. However, the technique is quite difficult and poses several challenges that limit its widespread adoption. To overcome these issues, a novel lateral vestibular approach (LaVA) was explored in cadavers. Study using 7 fresh human cadavers that were dissected using open and endoscopic techniques to explore the feasibility of a transoral vestibular approach to the central neck without gas insufflation. This novel approach resulted in wide access to the central neck and allowed for a total thyroidectomy and central neck dissection while preserving the marginal mandibular and mental nerves. LaVA permits excellent access to the central neck with a wide working space without the need for gas insufflation and overcomes many of the limitations of current transoral endoscopic approaches to the central neck.