Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy

Area of Science:

• Endocrinology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Traditional thyroidectomy can leave visible neck scars.
• Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is an emerging technique for thyroid surgery.
• Minimally invasive approaches aim to reduce surgical morbidity and improve cosmetic outcomes.

Purpose of the Study:

• To describe the technique of transoral endoscopic thyroidectomy vestibular approach (TOETVA) for thyroid lobectomy.
• To detail the simultaneous performance of prophylactic ipsilateral central neck dissection in patients with papillary thyroid cancer (PTC).
• To outline the surgical steps, including workspace creation, specimen extraction, parathyroid management, and closure.

Main Methods:

• The transoral endoscopic thyroidectomy vestibular approach (TOETVA) involves a vestibular incision for endoscopic instruments.
• Workspace is created using a skin suspension device and CO2 insufflation.
• Medial-to-lateral lobectomy and ipsilateral central neck dissection are performed, with parathyroid auto-transplantation.
• Specimen extraction through the main incision and closure with absorbable sutures.

Main Results:

• The manuscript details the procedural steps for TOETVA and central neck dissection.
• Emphasis is placed on preserving parathyroid function through auto-transplantation.
• Postoperative management includes intravenous and oral antibiotics.

Conclusions:

• Transoral endoscopic thyroidectomy vestibular approach (TOETVA) provides a viable, scarless option for thyroid lobectomy and central neck dissection.
• The technique facilitates simultaneous management of papillary thyroid cancer and parathyroid preservation.
• Further studies may evaluate long-term outcomes and patient satisfaction.