Transoral endoscopic thyroidectomy: preliminary experience in Italy

Gianlorenzo Dionigi, Alessandro Bacuzzi, Matteo Lavazza, Davide Inversini, Luigi Boni, Stefano Rausei, Hoon Yub Kim, Angkoon Anuwong

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is a feasible novel surgical procedure that does not need visible incisions. We describe our initial experience with TOETVA. We recruited 15 patients who were willing to undergo TOETVA. Inclusion criteria were (a) patients who had a neck ultrasound (US) with a estimated thyroid diameter not larger than 10 cm; (b) US estimated gland volume ≤45 mL; (c) nodule size ≤50 mm; (d) a benign tumor, such as a thyroid cyst, single-nodular goiter, or multinodular goiter; (e) follicular neoplasm; (f) papillary microcarcinoma without evidence of metastasis. The procedure is carried out through a three-port technique placed at the oral vestibule, one 10-mm port for 30° endoscope and two additional 5-mm ports for dissecting and coagulating instruments. CO2 insufflation pressure is set at 6 mmHg. An anterior cervical subplatysmal space is created from the oral vestibule down to the sternal notch, laterally to the sternocleidomastoid muscle. Thyroidectomy is done fully endoscopically using conventional endoscopic instruments and intraoperative neuromonitoring. There were 34% total thyroidectomies and 66% hemithyroidectomies. All TOETVA procedures were performed successfully with no conversions. The mean operative time was 87.6 (59–118) min for lobectomy and 107.6 (99–135) min for bilateral procedure. We observed one case of transient postoperative hypocalcemia. There was no recurrent laryngeal nerve palsy. The cosmetic result was excellent in all patients. This is the first case series of TOETVA in Italy. TOETVA may provide a method for ideal cosmetic results. The results are encouraging, and we are optimistic about the future expansion of its applicability.

Original languageEnglish
Pages (from-to)225-234
Number of pages10
JournalUpdates in Surgery
Volume69
Issue number2
DOIs
Publication statusPublished - 2017 Jun 1

Fingerprint

Thyroidectomy
Italy
Cosmetics
Thyroid Gland
Nodular Goiter
Vocal Cord Paralysis
Insufflation
Hypocalcemia
Endoscopes
Goiter
Operative Time
Cysts
Neoplasms
Neck
Neoplasm Metastasis
Pressure
Muscles

Keywords

  • Endoscopic thyroidectomy
  • Minimally invasive thyroidectomy
  • Thyroid surgery

ASJC Scopus subject areas

  • Surgery

Cite this

Dionigi, G., Bacuzzi, A., Lavazza, M., Inversini, D., Boni, L., Rausei, S., ... Anuwong, A. (2017). Transoral endoscopic thyroidectomy: preliminary experience in Italy. Updates in Surgery, 69(2), 225-234. https://doi.org/10.1007/s13304-017-0436-x

Transoral endoscopic thyroidectomy : preliminary experience in Italy. / Dionigi, Gianlorenzo; Bacuzzi, Alessandro; Lavazza, Matteo; Inversini, Davide; Boni, Luigi; Rausei, Stefano; Kim, Hoon Yub; Anuwong, Angkoon.

In: Updates in Surgery, Vol. 69, No. 2, 01.06.2017, p. 225-234.

Research output: Contribution to journalArticle

Dionigi, G, Bacuzzi, A, Lavazza, M, Inversini, D, Boni, L, Rausei, S, Kim, HY & Anuwong, A 2017, 'Transoral endoscopic thyroidectomy: preliminary experience in Italy', Updates in Surgery, vol. 69, no. 2, pp. 225-234. https://doi.org/10.1007/s13304-017-0436-x
Dionigi G, Bacuzzi A, Lavazza M, Inversini D, Boni L, Rausei S et al. Transoral endoscopic thyroidectomy: preliminary experience in Italy. Updates in Surgery. 2017 Jun 1;69(2):225-234. https://doi.org/10.1007/s13304-017-0436-x
Dionigi, Gianlorenzo ; Bacuzzi, Alessandro ; Lavazza, Matteo ; Inversini, Davide ; Boni, Luigi ; Rausei, Stefano ; Kim, Hoon Yub ; Anuwong, Angkoon. / Transoral endoscopic thyroidectomy : preliminary experience in Italy. In: Updates in Surgery. 2017 ; Vol. 69, No. 2. pp. 225-234.
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