Modified transoral endoscopic thyroid surgery for treatment of thyroid cancer: operative steps and video

Abstract

In this video we describe a kind of modified transoral endoscopic thyroid surgery involving meticulous dissection of mental nerve. Inclusion criteria are: the diameter of benign tumors such as thyroid cyst, nodular goiter were limited less than 50 mm; the malignant thyroid tumors including follicular and papillary microcarcinoma were defined as a papillary carcinoma <2 cm in diameter and endoscopic surgery required for the patient. A 6 cm arc-shaped incision was designed at oral vestibule. The branches of mental nerves at both sides were identified and exposed carefully. A 10 mm trocar was placed at the midpoint of the vestibule. Two 5 mm trocars were separately inserted into the vestibule at lateral or medial of the medial branches of the mental nerve. Thyroidectomy and central lymph node dissection was done fully endoscopically using conventional endoscopic instruments.

Transoral endoscopic thyroidectomy vestibular approach in a patient with Class III goitre (operative steps and video)

“…The indications according to the size are listed in Table 2. Other indications: no evidence of clinical or radiographic lateral nodal metastasis or distant metastasis and no previous surgery or radiation of the neck (3)(4)(5)(6)8,9,13,14). No severe oral cavity infection, such as an abscess (3,5,13).…”

“…No severe oral cavity infection, such as an abscess (3,5,13). No invasion of the esophagus or trachea (4,8,9). No history of chin augmentation by a silicone implant (13).…”

“…This technique was first mentioned by Xiaowei Peng and colleagues in 2017 (9). In 2019 he conducted a further study (10), a comparative trial between one group with mental nerve dissection and another group with the conventional three incisions, the most commonly known way of incision in TOETVA (3,13,16).…”

The Clinical Application of Novel Mini Transoral Endoscopic Thyroidectomy to Avoid Numbness and Pain in Patients with Thyroidectomy

“…This process entailed a paradigm shift, away from the traditional transcervical thyroidectomy, toward a more re ned technique in an attempt to hide scarring and improve cosmetics in the neck region [2,3] . Of the currently available endoscopic techniques, the transoral endoscopic thyroidectomy vestibular approach provides a truly scarless approach with relatively direct access to the thyroid and reduced tissue dissection [2,4] . More recently, there has been development of a technique known as the transoral endoscopic thyroidectomy vestibular approach [5] .…”