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<p>Endoscopic thyroidectomy (ET) has a cosmetic advantage over conventional surgery. The transoral endoscopic thyroidectomy via the Vestibular approach (TOETVA) is the shortest route to simultaneously approach both thyroid lobes. It is a scar-free thyroid surgery, making it a cosmetically superior approach. This study aimed to evaluate our initial experience and outcomes of the TOETVA. From June 2017 to May 2024, 109 patients composed of 98 women and 11 men (M:F = 1:9) were offered TOETVA. Mean age was 32.01 ± 11.50&#xa0;years; the majority reported early (Mean duration of goitre = 25.41 ± 43.89&#xa0;months), diagnosed with STN, and the commonest FNAC was a colloid goitre (76.15%). 87.2% underwent hemithyroidectomy (HT), 7.3% total thyroidectomy (TT), 3.7% TT with central compartment neck dissection (CCLND) and 1.8% converted to open. The mean duration of surgery for HT was 136&#xa0;min, TT 186&#xa0;min, and TT + CCLND 208&#xa0;min. The mean specimen size was 4.40 ± 0.97&#xa0;cm, weight 13.97 ± 8.59&#xa0;g, and hospital stay was 2.73 ± 1.17&#xa0;days. On histopathology 54.3% colloid goitre (54.3%), 14.3% MNG, 13.3% Follicular adenoma, 9.5% PTC, 5.7% thyroiditis and 1.9% FTC. The complications include 6.5% temporary hypocalcemia (2.8% required IV calcium), 2.8 and temporary change in voice and 5.5% swelling around the neck. Seroma formation in a few, none required aspiration. Excellent cosmetic result on follow-up. We conclude that TOETVA has fairly stringent inclusion criteria due to limitations inherent to this approach by site of access and limited operating space. This approach offers total scar-free thyroid surgery, and it should be the procedure of choice for every eligible patient of ET.</p>

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Trans-Oral Endoscopic Thyroidectomy via Vestibular Approach (TOETVA): Single-Surgeon Experience of more than 100 Cases

  • 期刊论文

  • 发表日期：

    2025年3月28日

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  • Gyan Chand,
  • Prathyusha Godi,
  • Madhu Kumari,
  • Aakriti Yadav

摘要

Endoscopic thyroidectomy (ET) has a cosmetic advantage over conventional surgery. The transoral endoscopic thyroidectomy via the Vestibular approach (TOETVA) is the shortest route to simultaneously approach both thyroid lobes. It is a scar-free thyroid surgery, making it a cosmetically superior approach. This study aimed to evaluate our initial experience and outcomes of the TOETVA. From June 2017 to May 2024, 109 patients composed of 98 women and 11 men (M:F = 1:9) were offered TOETVA. Mean age was 32.01 ± 11.50 years; the majority reported early (Mean duration of goitre = 25.41 ± 43.89 months), diagnosed with STN, and the commonest FNAC was a colloid goitre (76.15%). 87.2% underwent hemithyroidectomy (HT), 7.3% total thyroidectomy (TT), 3.7% TT with central compartment neck dissection (CCLND) and 1.8% converted to open. The mean duration of surgery for HT was 136 min, TT 186 min, and TT + CCLND 208 min. The mean specimen size was 4.40 ± 0.97 cm, weight 13.97 ± 8.59 g, and hospital stay was 2.73 ± 1.17 days. On histopathology 54.3% colloid goitre (54.3%), 14.3% MNG, 13.3% Follicular adenoma, 9.5% PTC, 5.7% thyroiditis and 1.9% FTC. The complications include 6.5% temporary hypocalcemia (2.8% required IV calcium), 2.8 and temporary change in voice and 5.5% swelling around the neck. Seroma formation in a few, none required aspiration. Excellent cosmetic result on follow-up. We conclude that TOETVA has fairly stringent inclusion criteria due to limitations inherent to this approach by site of access and limited operating space. This approach offers total scar-free thyroid surgery, and it should be the procedure of choice for every eligible patient of ET.