How I do itVideo-assisted thyroid lobectomy through a small wound in the submandibular area
Section snippets
Patients
We treated 39 women ranging in age from 18 to 55 years (mean 33.8). All were diagnosed with benign thyroid nodules by both ultrasonography and fine needle aspiration cytology. All gave informed consent for the surgical procedure. Direct preoperative laryngoscopic examination showed normal vocal cord function in all 39 patients.
Operative procedures
The patient is put under general anesthesia with the neck in a natural or slightly extended position. The patient is prepared and draped as in conventional thyroidectomy
Results
All patients underwent total lobectomy without conversion to traditional cervicotomy. The mean operation time was 57 minutes (range 36 to 85) and mean blood loss was 24 mL. The tumor size ranged from 1.9 to 5.5 cm (mean 3.1 cm). Follicular adenoma was the final pathologic diagnosis in 29 patients, and adenomatous goiter in 12. There was micropapillary cancer (4 × 3 mm) coexisting with follicular adenoma in 1 patient. This patient is being carefully monitored by thyroglobulin assay and
Comments
Several endoscopic thyroidectomy procedures have been described [2], [3], [4] for treatment of the thyroid nodule [5], [6], [7], [8], [9], [10], [11], [12], [13], but none has become widely used as other endoscopic procedures for abdominal and thoracic surgery. Endoscopic surgery is indicated when a cosmetic benefit can be achieved, but it must also be shown that it will be less invasive, that it is safe, and that the same surgical outcome will be produced as would be by conventional surgery.
References (15)
- et al.
Endoscopic parathyroidectomyreport of an initial experience
Surgery
(1998) - et al.
Video-assisted neck surgeryendoscopic resection of thyroid tumors with a very minimal neck wound
J Am Coll Surg
(1999) - et al.
Minimally invasive, totally gasless video-assisted thyroid lobectomy
Am J Surg
(1999) - et al.
Endoscopic neck surgery by the axillary approach
J Am Coll Surg
(2000) - et al.
Video-assisted endoscopic thyroidectomy
Am J Surg
(2000) Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism
Br J Surg
(1996)- et al.
Minimally invasive videoscopic parathyroidectomya feasibility study in dogs and humans
J Laparoendosc Adv Surg Tech A
(1997)
Cited by (67)
Transoral endoscopic thyroidectomy vestibular approach (TOETVA): A novel surgical technique for scarless thyroidectomy in pediatric surgery
2022, Journal of Pediatric SurgeryCitation Excerpt :One of the most critical problems in thyroid surgery is visible neck scars after surgery, which are sometimes considered as important as the final treatment outcomes, especially in adolescents and their parents with severe cosmetic concerns. In literature, various surgical techniques have been reported to prevent surgical scar formation after thyroid surgery [1–5]. Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is a novel surgical procedure that has been used more frequently in adults in recent years [6–10].
Minimally invasive compared with conventional thyroidectomy for nodular goitre
2014, Best Practice and Research: Clinical Endocrinology and MetabolismCitation Excerpt :On a technical note, MNIT comes closest to the conventional open thyroidectomy. It can be performed through a central [3,20] or lateral [21–23] neck incision smaller than 3 cm under video-endoscopic or complete endoscopic guidance, or without endoscopic guidance through a much longer, 3–6 cm [24–26] neck incision that barely qualifies as “minimal”. A total of 10 prospective randomized studies [27–36] and five systematic reviews [37–41] examined the minimally invasive video-assisted (MIVAT) central approach, which is the most commonly used variant.
Thyroidectomy: A novel endoscopic oral vestibular approach
2014, Surgery (United States)The Advantages of Applying a 5-mm Endoscope in the Transoral Endoscopic Thyroidectomy Vestibular Approach
2022, Surgical Laparoscopy, Endoscopy and Percutaneous TechniquesTransoral Endoscopic Thyroidectomy by Vestibular Approach for Differentiated Thyroid Cancer Intraoperatively Invading Strap Muscle
2022, Surgical Laparoscopy, Endoscopy and Percutaneous TechniquesComparison of Transoral Endoscopic Thyroidectomy Vestibular Approach and Conventional Open Thyroidectomy in Benign Thyroid Tumors
2022, Indian Journal of Surgical Oncology