Transoral Endoscopic Thyroidectomy by a Vestibular Approach with Endoscopic Retractor : Experience with The First 132 Patients
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Background : Transoral endoscopic thyroidectomy by a vestibular approach (TOETVA) is a novel technique for thyroid cancer operation. The aim of this study was to report on our initial experiences with TOETVA with endoscopic retractor for the management of thyroid carcinoma.
Methods : From September 2016 to April 2018, 132 patients with thyroid cancer underwent TOETVA. We used a three-port technique through the oral vestibule with endoscopic retractor, and thyroidectomy with ipsilateral central compartment dissection was performed endoscopically using conventional laparoscopic instruments.
Results: All patients had papillary thyroid carcinoma. Less than total or total thyroidectomy with ipsilateral central compartment node dissection was performed (124 vs. 8). The mean operation time was 87.6 min (range, 56-213 min). The average number of lymph nodes resected was 2.6 (range, 1-12). Six patients experienced a transient hoarseness, which was resolved within 3 months. Most of the patients could return home within 3 days after surgery.
Discussion & Conclusions: In this large series from a single center, we found that TOETVA with endoscopic retractor can be performed safely and radically in selected patients with thyroid cancer.
Two Approaches to Level 5 Neck Dissection
- Jeff Blumberg