Starting a Transoral Thyroid and Parathyroid Surgery Program

Abstract

Purpose of Review To describe the necessary steps to facilitate safe implementation of a transoral thyroid and parathyroid surgery program. Recent Findings Transoral vestibular approaches to the central neck have been demonstrated to be safe and feasible, while avoiding the morbidity of a cutaneous scar. As operative volume expands from a select few high-volume centers, a framework for implementation has been recommended to allow the evidence-based outcomes to translate into clinical practice for new adopters of these techniques. These include securing institutional support, choosing the appropriate candidate (both patient and surgeon), appropriate case observation and instruction (live and cadaver), and adequate first-case preparation and knowledge of the learning curve(s) for the techniques. Summary The recommendations in this article provide a foundation from which a transoral thyroid and parathyroid program may be successfully built. An intricate understanding of conventional transcervical central neck surgery and institutional support are absolute prerequisites to safe and successful implementation of these transoral vestibular techniques.

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

“…There is an increasing number of transoral endoscopic thyroidectomy being performed worldwide [9,10] . With its ability to be completely scarless and with the most short and direct path to the thyroid, transoral endoscopic thyroidectomy vestibular approach is a logical next step in the evolution of endoscopic thyroid surgery [11] .…”

Transoral Thyroidectomy and Parathyroidectomy: Series of Cases

“…К настоящему времени наиболее популярной в мире является методика TOETVA, предложенная тайскими хирургами [7]. Интерес к новой методике только возрастает, о чем свидетельствуют работы, посвященные уточнению показаний и противопоказаний [12], стандартизации программ обучения хирургов [13], более пристальному изучению анатомических и гистологических нюансов [14]. При этом, трансоральная операция не представляется какой-то эксклюзивной, «штучной».…”

The role of surgeon‐performed ultrasound in transoral endoscopic thyroidectomy vestibular approach (TOETVA)

“…2 ) This allows a small cuff of thyroid tissue to be left if necessary. 15 , 16

Figure 2 Ultrasonographic demonstration of a solid right lower pole thyroid nodule with smooth borders that was benign on fine needle aspiration. This nodule was amenable to management with TOETVA.

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“… 15 Considerations include: strong administrative support, case observation and cadaveric dissection, appropriate patient selection, and awareness of the expected learning curve. 16 Additionally, surgeon-specific characteristics such as a high-volume of yearly open thyroidectomy and central neck cases, contribute to an in depth understanding of central neck anatomy and facilitate successful adoption of TOETVA.…”