Lessons Learned From a Faulty Transoral Endoscopic Thyroidectomy Vestibular Approach

Daqi Zhang, Che Wei Wu, Davide Inversini, Hoon Yub Kim, Angkoon Anuwong, Alessandro Bacuzzi, Gianlorenzo Dionigi

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


Background: Transoral endoscopic thyroidectomy via vestibular approach (TOETVA) is currently considered the most promisingly scarless approach to the thyroid and has gained more acceptance. Materials and Methods: We described a case of faulty TOETVA. Results: The faulty TOETVA resulted in pneumomediastinum, diffuse subcutaneous emphysema, prolonged surgery, and anesthesia. Conclusions: The important technical considerations during TOETVA, including the use of external retraction, the identification of the subplatysmal plane of dissection, CO2 insufflation settings, the learning curve, and patient selection, were described and discussed.

Original languageEnglish
JournalSurgical Laparoscopy, Endoscopy and Percutaneous Techniques
Publication statusAccepted/In press - 2018 Jul 2


  • endoscopic thyroidectomy
  • morbidity
  • pneumomediastinum
  • subcutaneous emphysema
  • transoral thyroidectomy

ASJC Scopus subject areas

  • Surgery

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