Transoral endoscopic thyroidectomy: Our experience in the first two years

  • Background: Recently, the concept of natural orifice transluminal endoscopic surgery (NOTES) has been introduced to thyroid surgery. With this approach, an endoscope is passed through a natural orifice (e.g., the mouth) into an internal organ (e.g., the thyroid).

    Methods: We reviewed the medical records of 63 consecutive cases who underwent transoral endoscopic thyroidectomy via a trivestibular approach between July 2016 and May 2018 in our hospital.

    Results: We performed 63 transoral endoscopic thyroid surgeries in 62 patients. The average tumor diameter was 1.23 cm (range: 0.3–7.5 cm). Postoperative pathology revealed PTC in 52 cases (82.5%), nodular hyperplasia in seven (11.1%), follicular carcinomas in two (3.2%), a follicular adenoma in one (1.6%) and a hyalinizing trabeculae tumor in one (1.6%). All surgical margins were negative. Two patients exhibited transient vocal cord palsy and recovered within 2 months. One patient who developed vocal cord palsy has not yet recovered for more than 3months. Five patients who underwent total thyroidectomy developed transient hypocalcemia, but recovered within 3 months. Four patients without drain developed seroma, but resolved after aspiration. No sensory change or facial weakness around the lower lip was reported by any patient.

    Conclusions: The transoral endoscopic approach provides a short, direct route to the thyroid gland and seems to be safe and feasible. It is important to further develop and refine the surgical techniques. The approach is optimal, and will become widely used for thyroid surgery in the near future.

 

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