Preliminary Experience in Transoral Endoscopic Thyroid and Parathyroid Surgery in Argentina
Thyroid World Congress ePoster Library. Fernandez S. 06/20/19; 271990; 189
Sebastian Elias Fernandez
Sebastian Elias Fernandez
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Abstract
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BACKGROUND: In the last decades transoral endoscopic thyroidectomy vestibular approach (TOETVA) gained popularity for thyroid surgery. We published our initial experience with this novel technique. MATERIALS AND METHODS: Patients presented benign thyroid or parathyroid disease. Inclusion criteria consisted of ultrasound assessment: thyroid nodules no greater than 5 cm, total goiter diameter lesser than 10 cm. All nodules included were Bethesda II, III and IV. History of neck surgery, radiation or uncontrolled hyperthyroidism were excluded. Vestibular approach was used in all cases. Three ports technique was performed with a 10mm for central port and two 5mm ports for laterals. CO2 insufflation with a 6 mmHg pressure and accessory suspension sutures were used. Neuromonitoring of the laryngeal nerve was implemented in all procedures. RESULTS: Nine patients were recruited from September 2018 to February 2019. Average age: 38.6 years old (17-60). One resection of a parathyroid adenoma. Three thyroid lobectomies and five total thyroidectomies of which two required conversion to conventional surgery. The average surgical time: 123 minutes (110 - 140) for lobectomies, 155 minutes for total thyroidectomy (130 - 180). We reported one seroma and one hematoma, both managed in a conservative way. A tracheal perforation which requiered conversion for resolution. No recurrent laryngeal nerve palsy was neither observed nor postoperative hypocalcemia. Aesthetics outcomes were satisfactory. CONCLUSION: This series represents the first publication of TOETVA technique in Argentina. The results are acceptable in terms of complications and aesthetics goals. We feel encourage to gain further evidence of its safety and applicability.

BACKGROUND: In the last decades transoral endoscopic thyroidectomy vestibular approach (TOETVA) gained popularity for thyroid surgery. We published our initial experience with this novel technique. MATERIALS AND METHODS: Patients presented benign thyroid or parathyroid disease. Inclusion criteria consisted of ultrasound assessment: thyroid nodules no greater than 5 cm, total goiter diameter lesser than 10 cm. All nodules included were Bethesda II, III and IV. History of neck surgery, radiation or uncontrolled hyperthyroidism were excluded. Vestibular approach was used in all cases. Three ports technique was performed with a 10mm for central port and two 5mm ports for laterals. CO2 insufflation with a 6 mmHg pressure and accessory suspension sutures were used. Neuromonitoring of the laryngeal nerve was implemented in all procedures. RESULTS: Nine patients were recruited from September 2018 to February 2019. Average age: 38.6 years old (17-60). One resection of a parathyroid adenoma. Three thyroid lobectomies and five total thyroidectomies of which two required conversion to conventional surgery. The average surgical time: 123 minutes (110 - 140) for lobectomies, 155 minutes for total thyroidectomy (130 - 180). We reported one seroma and one hematoma, both managed in a conservative way. A tracheal perforation which requiered conversion for resolution. No recurrent laryngeal nerve palsy was neither observed nor postoperative hypocalcemia. Aesthetics outcomes were satisfactory. CONCLUSION: This series represents the first publication of TOETVA technique in Argentina. The results are acceptable in terms of complications and aesthetics goals. We feel encourage to gain further evidence of its safety and applicability.

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