TRANS ORAL ENDOSCOPIC THYROIDECTOMY VESTIBULAR APPROACH (TOETVA), CASE SERIES OF THE FIRST CLINICAL EXPERIENCE FROM PAKISTAN

Authors

  • Iqra Zakir Department of Otorhinolaryngology Liaquat National Postgraduate Medical Centre Karachi-Pakistan
  • Ahmad Nawaz Department of Otorhinolaryngology Liaquat National Postgraduate Medical Centre Karachi-Pakistan

DOI:

https://doi.org/10.55519/JAMC-01-10613

Keywords:

TOETVA, minimally invasive thyroid surgery

Abstract

Background: The objective of the study to assess the workability and cosmetic outcome of endoscopic thyroidectomy vestibular approach (TOETVA) and share results of underdeveloped country with the world about their first clinical experience. Methods: We performed TOETVA in 3 patients presenting with thyroid nodules in our hospital, between October 2020 and December 2020 at Liaquat National hospital. Three-port technique was used, one 10-mm port for camera and two 5-mm ports for working. All ports were passed through oral vestibule. The demographic data of the patients and surgical outcomes were retrospectively reviewed. The surgery was completed successfully in all 3 patients. The operative time was between 120–150 mins. Results: No complications such as recurrent laryngeal nerve palsy, mental nerve injury or parathyroid gland injury damage occurred in patients postoperatively. No visible scarring occurred in the patients postoperatively. Patients remain stable after surgery and got discharged next day. No complications were noted in 6 months follow up. Conclusion: TOETVA is safe, feasible, effective and scar free option as compared to conventional thyroid surgery.

Author Biographies

Iqra Zakir, Department of Otorhinolaryngology Liaquat National Postgraduate Medical Centre Karachi-Pakistan

 

Ahmad Nawaz , Department of Otorhinolaryngology Liaquat National Postgraduate Medical Centre Karachi-Pakistan

 

References

Yu JJ, Bao SL, Yu SL, Zhang DQ, Loo WT, Chow LW, et al. Minimally invasive video-assisted thyroidectomy for the early-stage differential thyroid carcinoma. J Transl Med 2012;10(1):13.

Gagner M. Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism. Br J Surg 1996;83(6):875.

Hüscher CS, Chiodini S, Napolitano C, Recher A. Endoscopic right thyroid lobectomy. Surg Endosc 1997;11(8):877.

Miccoli P, Materazzi G. Minimally invasive, video-assisted thyroidectomy (MIVAT). Surg Clin North Am 2004;84(3):735–41.

Witzel K, Von Rahden BHA, Kaminski C, Stein HJ. Transoral access for endoscopic thyroid resection. Surg Endosc 2008;22(8):1871–5.

Wilhelm T, Harlaar JJ, Kerver A, Kleinrensink GJ, Benhidjeb T. Surgical anatomy of the floor of the oral cavity and the cervical spaces as a rationale for trans-oral, minimal-invasive endoscopic surgical procedures: results of anatomical studies. Eur Arch Otorhinolaryngol 2010;267(8):1285–90.

Wilhelm T, Metzig A. Endoscopic minimally invasive thyroidectomy: first clinical experience. Surg Endosc. 2010;24(7):1757–8.

Nakajo A, Arima H, Hirata M, Mizoguchi T, Kijima Y, Mori S, et al. Trans-Oral Video-Assisted Neck Surgery (TOVANS). A new transoral technique of endoscopic thyroidectomy with gasless premandible approach. Surg Endosc 2013;27(4):1105–10.

Inabnet WB 3rd, Jacob BP, Gagner M. Minimally invasive endoscopic thyroidectomy by a cervical approach. Surg Endosc 2003;17(11):1808–11.

Cho YU, Park IJ, Choi KH, Kim SJ, Choi SK, Hur YS, et al. Gasless endoscopic thyroidectomy via an anterior chest wall approach using a flap-lifting system. Yonsei Med J 2007;48(3):480–7.

Ikeda Y, Takami H, Sasaki Y, Takayama J, Niimi M, Kan S. Clinical benefits in endoscopic thyroidectomy by the axillary approach. J Am Coll Surg 2003;196(2):189–95.

Lee J, Chung WY. Current status of robotic thyroidectomy and neck dissection using a gasless transaxillary approach. Curr Opin Oncol 2012;24(1):7–15.

Choe JH, Kim SW, Chung KW, Park KS, Han W, Noh DY, et al. Endoscopic thyroidectomy using a new bilateral axillo-breast approach. World J Surg 2007;31(3):601–6.

Koh YW, Kim JW, Lee SW, Choi EC. Endoscopic thyroidectomy via a unilateral axillo-breast approach without gas insufflation for unilateral benign thyroid lesions. Surg Endosc 2009;23(9):2053–60.

Anuwong A. Transoral endoscopic thyroidectomy vestibular approach: a series of the first 60 human cases. World J Surg 2016;40(3):491–7.

Hannan SA. The magnificent seven: a history of modern thyroid surgery. Int J Surg 2006;4(3):187–91.

Tan CTK, Cheah WK, Delbridge L. “Scarless” (in the neck) endoscopic thyroidectomy (SET): an evidence-based review of published techniques. World J Surg 2008;32(7):1349–57.

Yeung GHC. Endoscopic thyroid surgery today: a diversity of surgical strategies. Thyroid 2002;12(8):703–6.

Foley CS, Agcaoglu O, Siperstein AE, Berber E. Robotic transaxillary endocrine surgery: a comparison with conventional open technique. Surg Endosc 2012;26(8):2259–66.

Anuwong A, Sasanakietkul T, Jitpratoom P, Ketwong K, Kim HY, Dionigi G, et al. Transoral endoscopic thyroidectomy vestibular approach (TOETVA): indications, techniques and results. Surg Endosc 2018;32(1):456–65.

Published

2023-01-16