Transoral endoscopic thyroidectomy via vestibular approach: Operative steps and video

Gianlorenzo Dionigi, Alessandro Bacuzzi, Matteo Lavazza, Davide Inversini, Vincenzo Pappalardo, Luigi Boni, Stefano Rausei, Marcin Barczynski, Ralph P. Tufano, Hoon Yub Kim, Angkoon Anuwong

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    31 Citations (Scopus)


    In this video we describe transoral endoscopic thyroidectomy vestibular approach (TOETVA). Inclusion criteria are (I) patients who had a ultrasonographically (US) estimated thyroid diameter not larger than 10 cm; (II) US estimated gland volume ≤45 mL; (III) nodule size ≤50 mm; (IV) a benign tumor, such as a thyroid cyst, single-nodular goiter, or multinodular goiter; (V) follicular neoplasm; (VI) papillary microcarcinoma without evidence of metastasis. The procedure is carried out through 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 sterncleidomuscles. Thyroidectomy is done fully endoscopically using conventional endoscopic instruments and intraoperative neuromonitoring (IONM).

    Original languageEnglish
    Pages (from-to)625-627
    Number of pages3
    JournalGland Surgery
    Issue number6
    Publication statusPublished - 2016


    • Instruments and intraoperative neuromonitoring (IONM)
    • Thyroidectomy
    • Transoral
    • Transoral endoscopic thyroidectomy vestibular approach (TOETVA)
    • Vestibular approach

    ASJC Scopus subject areas

    • Surgery


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