Transoral endoscopic thyroidectomy via vestibular approach (TOETVA): initial experience

Abstract

Background: We present our first four thyroidectomies performed via endoscopic vestibular approach.

Methods: Retrospective data was collected for all four patients who had endoscopic thyroid surgeries performed at a single centre between November 2023 and September 2024. Information on patient demographics, surgical technique and postoperative outcomes was collected and reviewed.

Outcomes: All four patients had transoral endoscopic thyroidectomy vestibular approach (TOETVA) successfully completed; conversion to traditional trans-cervical incision was not required in any of the cases. All patients were females aged between 29 and 63. The average operative time for the procedure was 210 minutes. The blood loss was negligible; the average length of hospital stay was 24 hours. No drains were used. No recurrent laryngeal nerve or mental nerve injuries were noted. No patient required completion thyroidectomy, as the histopathological analysis showed benign thyroid nodules in all four cases.

Conclusion: TOETVA is a safe and viable option for thyroid surgery and should be routinely considered for patients who require thyroid surgery and are eligible for it. Careful patient selection and counselling are paramount to avoid undesirable outcomes. The procedure yields excellent outcomes when performed by an experienced laparoscopic and thyroid surgeon.