Ann Surg Treat Res.  2016 Nov;91(5):269-272. 10.4174/astr.2016.91.5.269.

Transoral endoscopic thyroidectomy via the trivestibular route

• Park JO
• Kim MR
• Kim DH
• Lee DK

• KMID: 2356379
• DOI: http://doi.org/10.4174/astr.2016.91.5.269

Abstract

We recently experienced a case of transoral endoscopic thyroidectomy via the trivestibular approach. We identified and preserved all neighboring critical structures during surgery. The patient was discharged on postoperative day 3. There were no complications in thyroid function, vocal cord function, or lower lip sense. Transoral endoscopic thyroidectomy via a trivestibular approach provides a short and direct route to the thyroid and an adequate workspace without a skin incision. Therefore, it is worthwhile to develop and refine the surgical techniques of this promising new surgical approach.

Keyword

Thyroidectomy; Thyroid; Minimally invasive surgical procedures; Endoscopy

MeSH Terms

Endoscopy
Humans
Lip
Minimally Invasive Surgical Procedures
Skin
Thyroid Gland
Thyroidectomy*
Vocal Cords

Figure

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  Fig. 1 Ultrasonography showing a 2-cm tumor located in the right upper thyroid gland (arrowheads).

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  Fig. 2 Operative views at each surgical step. (A) A 2-cm curvilinear incision was made in the midline of the vestibule. (B) A subplatysmal working space was created. (C) The operator was seated by the patient's head and the assistant controlled the endoscope. (D) The upper pole was divided. (E) The recurrent laryngeal nerve was identified.

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  Fig. 3 Photograph showing the postoperative scar. No visible scar was observed in the neck 1 week after surgery, and the cosmetic outcome was good.

Reference

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2. Benhidjeb T, Wilhelm T, Harlaar J, Kleinrensink GJ, Schneider TA, Stark M. Natural orifice surgery on thyroid gland: totally transoral video-assisted thyroidectomy (TOVAT): report of first experimental results of a new surgical method. Surg Endosc. 2009; 23:1119–1120.

3. Anuwong A. Transoral endoscopic thyroidectomy vestibular approach: a series of the first 60 human cases. World J Surg. 2016; 40:491–497.

4. Park JO, Kim CS, Song JN, Kim JE, Nam IC, Lee SY, et al. Transoral endoscopic thyroidectomy via the tri-vestibular routes: results of a preclinical cadaver feasibility study. Eur Arch Otorhinolaryngol. 2014; 271:3269–3275.