Transoral endoscopic thyroidectomy: current state of the art—a systematic literature review and results of a bi-center study

Wilhelm, Thomas; Wu, Guojun; Teymoortash, Afshin; Güldner, Christian; Günzel, Thomas; Hoch, Stefan

doi:10.21037/tcr.2016.12.62

Cited by 13 publications

(26 citation statements)

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“…The clinical evidence was sufficient to demonstrate that a sublingual approach may not be appropriate due to many complications which occurred. In particular, some infections were observed in certain series (10,12). In the literature review, there was no infection in the oral vestibular approach.…”

Section: Discussionmentioning

confidence: 95%

“…To ensure patients' safety, clinical evidence is the most important matter of concern before widespread use of that technique. For transoral endoscopic thyroidectomy, there were many studies in animals and cadavers before application to clinical practice (8)(9)(10)(11)(12)(13)(14)(15). The transoral approach is to operate from the mouth which is contaminated with many bacteria, to the neck, which is the sterile area.…”

Section: Discussionmentioning

confidence: 99%

“…There was infection at the sublingual incision and neck area in 6 cases. Conversion to open surgery was needed in 3 cases (12).…”

Section: Combined Sublingual and Oral Vestibular Approachmentioning

confidence: 99%

“…A benefit of this innovative thyroid technique is its excellent cosmetic outcome due to scarless surgery. Despite its benefits, however, this procedure has been considered experimental due to the limitations of the previous sublingual approach (9)(10)(11)(12). The oral vestibular approach has since been introduced with better clinical outcomes (13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

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Transoral endoscopic thyroidectomy using vestibular approach: updates and evidences

2017

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Recently, natural orifice transluminal endoscopic surgery (NOTES) has been applied in thyroid surgery with transoral access. The benefit of transoral endoscopic thyroidectomy is the potential for scar-free surgery. However, there are many concerns over some aspects, such as infection, recurrent laryngeal nerve injury, and oncological outcome. In this paper, we have reviewed the development history and the current clinical evidence of this innovative surgery. We conclude that the transoral endoscopic thyroidectomy vestibular approach (TOETVA) is feasible and can be considered no longer an experimental operation.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

“…There was infection at the sublingual incision and neck area in 6 cases. Conversion to open surgery was needed in 3 cases (12).…”

Section: Combined Sublingual and Oral Vestibular Approachmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Transoral endoscopic thyroidectomy using vestibular approach: updates and evidences

2017

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“…Authors whom had completed ten or more cases endoscopically were considered to be high volume, while all articles with human robotic cases were reviewed given the relatively limited amount of literature. Publications that did not give formal inclusion or exclusion criteria for their cohort were excluded (33,37). Inclusion and exclusion criteria for each of these studies were then reviewed and compiled.…”

Section: Methodsmentioning

confidence: 99%

Indications and contraindications to transoral thyroidectomy

Razavi

Russell

2017

Ann. Thyroid

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Patient motivation to avoid neck scarring has been a strong impetus in the development of remote access approaches to the thyroid, including transoral robotic or endoscopic thyroidectomy vestibular approach (TOR/ETVA). TOR/ETVA continues to become more prevalent given its early success in North America and the demonstration of its safety and efficacy in Asia. As more surgeons perform this procedure, it is important that specific and uniform indications and contraindications exist to prevent surgical complications due to poor patient selection. In this article, we review the existing English literature regarding TOR/ETVA and compile the inclusion and exclusion criteria of individual authors for both robotic and endoscopic techniques to date. We then resolve differences in the existing literature to provide recommended indications and contraindications to TOR/ETVA based on both our review and our own experience with TOR/ETVA to date. The following are our resultant recommended indications for TOR/ETVA: patient history of hypertrophic scarring or motivation to avoid a cervical neck incision with a maximal thyroid diameter ≤ 10 cm and dominant nodule ≤6 cm, with one of the following pathologic criteria; benign lesion, multinodular goiter, indeterminate nodule, or suspicious lesions/well-differentiated thyroid carcinomas ≤ 2 cm. Recommended contraindications to TOR/ETVA are as follows: history of head & neck surgery, history of head, neck, or upper mediastinal irradiation, inability to tolerate general anesthesia, evidence of clinical hyperthyroidism, preoperative recurrent laryngeal nerve palsy, lymph node metastasis, extrathyroidal extension including tracheal or esophageal invasion, oral abscesses, substernal thyroidal extension, or failure to meet inclusion criteria as above. Relative contraindications include smoking and other oral pathology, and surgeons should be aware that morbid obesity may make it difficult to raise skin flaps.

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Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA)—a Case Series Analysis

Shah

2022

Indian J Surg

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Transoral endoscopic thyroidectomy: current state of the art—a systematic literature review and results of a bi-center study

Cited by 13 publications

References 0 publications

Transoral endoscopic thyroidectomy using vestibular approach: updates and evidences

Transoral endoscopic thyroidectomy using vestibular approach: updates and evidences

Indications and contraindications to transoral thyroidectomy

Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA)—a Case Series Analysis

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