TOETVA: moving forward with energy devices

  • Toetva is a rapidly accepted option for thyroid resection. Indications are broader and thyroid tumors are not a contra indication in most initial cases. In addition, central compartment neck dissection can be safely executable at the same time of the thyroidectomy. Hence, more challenging procedures are growing to be frequent thus demanding the surgeon to be more resourceful in other to accomplish a proper resection. In this regard, new technologies are constantly becoming  available albeit developed for general surgery some of them can be applicable to the cervical approach. As a matter of a fact, that is a great leap toward the endoscopic compared to the robotic transoral resection of the thyroid.  Since TOETVA is a relative new procedure, there isn´t an unquestionable technique  for the procedure and as the options for endoscopic procedures are more numerous when comparing to the open approach the surgeon should pursuit the device that most comfortably and safely aids in his procedure. In this video we demonstrate two new devices (L-Hook – Covidian and Thunderbeat – Olympus). Both devices rational is to combine  different energy sources in one instrument, the first uses an advancer bipolar with a true cautery in the shape of a hook and the latter combines advanced bipolar with harmonic energy. Understanding the functional aspects of each device, how its energy is applied and its risks are paramount for a safe and fast procedure.

 

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