Transoral thyroid and parathyroid surgery—Development of a new transoral technique

Karakas, Elias; Steinfeldt, Thorsten; Gockel, Andreas; Schlosshauer, Thorsten; Dietz, Carsten; Jäger, Jens; Westermann, Reiner; Sommer, Frank; Richard, Hans Rudolf; Exner, Cornelia; Sesterhenn, Andreas M.; Bartsch, Detlef K.

doi:10.1016/j.surg.2010.12.016

Cited by 77 publications

(54 citation statements)

References 26 publications

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“…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%

“…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: 99%

Section: Introductionmentioning

confidence: 99%

Transoral endoscopic thyroidectomy using vestibular approach: updates and evidences

2017

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“…No complications were observed and all cases could be completed transorally. The same group further developed their surgical technique in 2011 (29). Using a special cervicoscope, transoral hemithyroidectomy was performed in ten living pigs and transoral parathyroidectomy in two patients.…”

Section: Review Of the Literaturementioning

confidence: 99%

Robotic and endoscopic transoral thyroidectomy: feasibility and description of the technique in the cadaveric model

et al. 2017

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Background: Numerous new approaches have been described over the years to improve the cosmetic outcomes of thyroid surgery. Transoral approach is a new technique that aims to achieve superior cosmetic outcomes by concealing the incision in the oral cavity.Methods: Transoral thyroidectomy through vestibular approach was performed in two institutions on cadaveric models. Procedure was performed endoscopically in one institution, while the robotic technique was utilized at the other.Results: Transoral thyroidectomy was successfully performed at both institutions with robotic and endoscopic techniques. All vital structures were identified and preserved.Conclusions: Transoral thyroidectomy has been performed in animal and cadaveric models, as well as in some clinical studies. Our initial experience indicates the feasibility of this approach. More clinical studies are required to elucidate its full utility.

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“…The vessels to the lower pole of the thyroid, the inferior thyroid artery, the trachea, and the recurrent laryngeal nerve are then visualised. The parathyroid glands on one side, posterior to the recurrent laryngeal nerve and cranial to the inferior thyroid artery (upper parathyroid gland), as well as anterior to the recurrent laryngeal nerve and distal to the thyroid artery (lower parathyroid gland), respectively, are localised and can be resected [29]. The topography of this approach is visualised in Figure 6.…”

Section: Szkolenie Podyplomowementioning

confidence: 99%

Od preparowania czterogruczołowego do technik małoinwazyjnych. Małoinwazyjna paratyroidektomia jako obecny standard chirurgii pierwotnej nadczynności przytarczyc

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Proczko-Markuszewska

et al. 2014

Endokrynologia Polska

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Complete surgical resection of hyperfunctioning parathyriod tissue is essential for the treatment of primary hyperparathyroidism. During recent years, minimally invasive surgery has been successfully applied in neck exploration, because of significant developments of guidance by intraoperative scans, the use of quick, intraoperative PTH assay, and also preoperative imaging procedures such as highresolution ultrasonography and sestamibi scintigraphy. The results of operations which are performed with minimally invasive techniques are comparable to those of conventional surgery, and provide advantages with regard to cosmetic result, length of hospitalisation, and reduced post-operative pain. StreszczenieCałkowite chirurgiczne usunięcie nadczynnej tkanki gruczołowej jest kluczowe dla leczenia pierwotnej nadczynności przytarczyc. Podczas ostatnich lat, techniki chirurgii małoinwazyjnej były z sukcesem wprowadzane do preparowania tkanek szyi. Było to możliwe dzięki opracowaniu śródoperacyjnych metod lokalizowania zmienionej tkanki, szybkim testom oznaczającym stężenie PTH w surowiczy, jak również doskonaleniu technik obrazowania przedoperacyjnego, takich jak ultrasonografia wysokiej rozdzielczości czy scyntygrafia z wykorzystaniem sestamibi. Wyniki operacji z wykorzystaniem technik małoinwazyjnych są porównywalne z wynikami technik konwencjonalnych oraz wiążą się z zaletami, takimi jak skrócony okres hospitalizacji, zmniejszenie bólu pooperacyjnego czy lepszy efekt kosmetyczny. (Endokrynol Pol 2014; 65 (3): 240-249) Słowa kluczowe: pierwotna nadczynność przytarczyc; konwencjonalne preparowanie tkanek szyi; minimalnie inwazyjna parathyroidectomia

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Transoral thyroid and parathyroid surgery—Development of a new transoral technique

Cited by 77 publications

References 26 publications

Transoral endoscopic thyroidectomy using vestibular approach: updates and evidences

Transoral endoscopic thyroidectomy using vestibular approach: updates and evidences

Robotic and endoscopic transoral thyroidectomy: feasibility and description of the technique in the cadaveric model

Od preparowania czterogruczołowego do technik małoinwazyjnych. Małoinwazyjna paratyroidektomia jako obecny standard chirurgii pierwotnej nadczynności przytarczyc

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