Transoral endoscopic thyroidectomy vestibular approach: Results after 53 first cases

Area of Science:

• Endocrine Surgery
• Minimally Invasive Surgery
• Head and Neck Surgery

Background:

• Trans Oral Endoscopic Thyroidectomy through Vestibular Approach (TOETVA) provides superior cosmetic outcomes by avoiding external neck incisions.
• This technique represents a novel approach for thyroid access with aesthetic advantages.

Purpose of the Study:

• To evaluate the safety and efficacy of TOETVA in a series of patients.
• To document surgical outcomes, complication rates, and cosmetic results of the TOETVA procedure.

Main Methods:

• A prospective observational study included 53 patients undergoing TOETVA between July 2017 and June 2021.
• Data collected included surgical indications, procedure types (lobectomy, total thyroidectomy, Central Neck Dissection), operative times, hospital stay, and complication rates.

Main Results:

• The study comprised predominantly women (98.1%) with a median age of 44. Thyroid nodules were the primary indication (73.6%).
• Median operative times were 14 min for port placement, 80 min for lobectomy, and 140 min for total thyroidectomy. Median hospital stay was 2 days.
• Complications included transient dysphonia (7.5%), permanent laryngeal nerve impairment (1.6%), transient hypoparathyroidism (18.2% for total thyroidectomy), and transient chin numbness in all patients.

Conclusions:

• TOETVA is a safe and effective surgical approach for selected patients, yielding optimal cosmetic results.
• Complications associated with the transoral approach were predominantly transient, supporting its feasibility.