Transoral endoscopic thyroidectomy: A case report

Pai, Vishwanath; Muthukumar, Pari; Prathap, Apoorva; Leo, Jayanth; Rekha, Assadi

doi:10.1016/j.ijscr.2015.04.010

Cited by 24 publications

(10 citation statements)

References 6 publications

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“…The surgical methods of radical surgery of thyroid cancer contained the traditional open surgery with Kocher's incision and the cosmetic surgery. Cosmetic surgery for thyroid tumor surgeries include ultrasound-guided ablation ( 8 ), minimally invasive video-assisted thyroidectomy ( 9 , 10 ), endoscopic surgery with incision far from the neck ( 11 – 13 ) and endoscopic surgery via natural orifices ( 12 , 13 ). In terms of cosmetics and minimally invasive effects, ultrasound-guided ablation has the most ideal qualities.…”

Section: Discussionmentioning

confidence: 99%

Complete endoscopic radical resection of thyroid cancer via an oral vestibule approach

et al. 2018

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The aim of the present study was to explore the feasibility, safety and effectiveness of complete endoscopic radical resection of thyroid cancer via an oral vestibule approach. A total of 60 patients with unilateral thyroid papillary carcinoma were divided into two groups. Half of them underwent complete endoscopic surgeries via an oral vestibule approach at the Department of Head and Neck Surgery of Fujian Cancer Hospital between November 2014 and December 2016. The other 30 patients underwent traditional open surgeries. All the patients underwent unilateral lobectomy and central neck dissection. Tumor diameter, surgery duration, intraoperative inflation pressure and end-tidal CO2 flow rate, intraoperative peak value of the partial pressure of end-tidal CO2, postoperative extubation time, the number of lymph nodes in the specimens of central neck dissection and postoperative complications were noted. From this data, tumor diameter (T stage of tumor), surgery duration, postoperative extubation time, the number of lymph nodes in the specimens of central neck dissection and postoperative complications were compared between the two groups. In the endoscopic group, 1 patient had a tracheal injury, and 1 patient had a submental skin perforation. Furthermore, 17 patients experienced transient numbness of the lower lip, 5 patients experienced an abnormal increase in the partial pressure of end-tidal CO2, and 2 patients experienced postoperative headache. No recurrent laryngeal nerve injury, postoperative bleeding, or infection was determined. There were no significant differences in all items of the indexes, compared with those patients who underwent open radical surgery. The lymph nodes from region VI may be well exposed and completely removed through this novel procedure with no visible scars, which not only ensured the surgery criterion was met, but also met the cosmetic requirements of the patients. The present study conducted procedures safely by surgeons highly skilled in performing laparoscopic surgery.

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Section: Discussionmentioning

confidence: 99%

Complete endoscopic radical resection of thyroid cancer via an oral vestibule approach

et al. 2018

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“…The transoral endoscopic technique, an adaptation of the concept of natural orifice transluminal endoscopic surgery (NOTES) to the neck, is a technique that promises to improve the aesthetic aspect by offering a scarless operation while retaining the advantages of minimally invasive surgery. 13 , 14 The pioneers of this technique were the group led by Witzel and his colleagues, 15 who presented their first paper on the subject in 2008. In their study on cadavers and live pigs, they managed to present a proof of concept that formed the basis for the extensive work that is being carried out by multiple groups around the world.…”

Section: Introductionmentioning

confidence: 99%

Transoral Endoscopic Thyroidectomy: A Systematic Review of the Practice So Far

Camenzuli

Schembri-Wismayer

Calleja‐Agius

2018

JSLS

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Background and Objectives:Thyroid disease largely affects young females, but the incidence is also increasing among males. In an effort to avoid the scarring of the neck that is synonymous with conventional thyroidectomy, endoscopic techniques have been developed over the years. The transoral endoscopic approach is the latest of these innovations that promises a scarless surgical outcome. This review evaluates whether this technique is safe and feasible in live patients and outlines the outcomes in published literature so far.Database:PubMed, Medline, BioMed Central, Cochrane Library, OVID and Web of Science were systematically searched by using a Medical Subject Heading (MeSH)–optimized search strategy. The selection of papers followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines after setting strict inclusion and exclusion criteria. Sixteen studies were included in the final analysis.Discussion:This systematic review presents cases of 785 patients. Surgeons in 15 of the studies used a completely vestibular approach, whereas those in the remaining 2 used the floor of the mouth for primary access. Conversion to open surgery took place in 1.3%. In total, 4.3% of patients experienced transient laryngeal nerve palsy, whereas 0.1% had permanent recurrent incidences of the condition. Transient hypocalcemia occurred in 7.4% of cases, with no recorded permanent cases. Carbon dioxide embolism occurred in 0.6% of cases, and another 0.6% had a deep-seated neck infection. The complication rates within the review were deemed acceptable and the overall technique feasible. A prospective randomized controlled trial was proposed to compare this technique with conventional thyroidectomy.

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“…Pai et al . [ 25 ] recently reported on a successful endoscopic hemithyroidectomy in a 21-year-old female patient, with a mean operative time of 2 h.…”

Section: Discussionmentioning

confidence: 99%

“…Transient surgical emphysema was reported by Pai et al . [ 25 ] in a patient who underwent transoral endoscopic hemithyroidectomy. However, no such events occurred during the post-operative period amongst the patients in the present study.…”

Section: Discussionmentioning

confidence: 99%

Transoral endoscopic total thyroidectomy vestibular approach: A case series and literature review

Sivakumar¹,

Amizhthu²

2018

J Min Access Surg

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Conventional open thyroidectomy is often associated with post-operative complications including nerve damage, voice disturbances, paraesthesias, adhesions and prominent scarring. Several endoscopic surgical techniques have been reported as alternatives to conventional thyroidectomy. Natural orifice transluminal endoscopic surgery is a promising approach which leaves no scar, produces few complications and affords faster discharge from care. Several studies have explored its utility in total thyroidectomy in patients with benign or malignant thyroid disease. Herein, we present a case series on the successful application of transoral endoscopic total thyroidectomy vestibular approach (TOETVA) in benign and malignant diseases of the thyroid. We performed TOETVA in 11 patients presenting with benign or malignant thyroid nodules in our hospital, between 1st January 2015 and 30th June 2016. The surgery was completed successfully in all patients with a pre-operative diagnosis of multinodular goitre. The surgery was performed under general anaesthesia and the mean operative time was 130 min. The mean blood loss was 2–3 cc. No incidence of recurrent laryngeal nerve injury, damage to mental nerve, parathyroid damage or peri-incisional adhesion occurred in the study participants. No visible scarring occurred in the patients following surgery. The patients had an uneventful recovery after the surgery and were discharged after 4 days. TOETVA is safe and effective in the surgical management of multinodular goitre and offers a scar-free alternative to conventional surgery.

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Transoral endoscopic thyroidectomy: A case report

Cited by 24 publications

References 6 publications

Complete endoscopic radical resection of thyroid cancer via an oral vestibule approach

Complete endoscopic radical resection of thyroid cancer via an oral vestibule approach

Transoral Endoscopic Thyroidectomy: A Systematic Review of the Practice So Far

Transoral endoscopic total thyroidectomy vestibular approach: A case series and literature review

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