ISSN 2667-7466 | E-ISSN 2667-7474
Invited Review
Patient and Surgeon Candidacy for Transoral Endoscopic Thyroid Surgery
1 Division for Endocrine and Minimally Invasive Surgery, Department of Human Pathology in Adulthood and Childhood ''G. Barresi'', University Hospital G. Martino, University of Messina, Messina, Italy  
2 Division of Thyroid Surgery, China-Japan Union Hospital Of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin, China  
3 Department of General Surgery, Ege University School of Medicine, İzmir, Turkey  
4 Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, USA  
5 Department of Surgery, KUMC Thyroid Center, Korea University Hospital, Korea University College of Medicine, Seoul, Korea  
Turk Arch Otorhinolaryngol 2019; 57: 105-108
DOI: 10.5152/tao.2019.18191
Key Words: Transoral endoscopic thyroidectomy, patient and surgeon candidacy, vestibular approach, learning curve
Abstract

 

The transoral thyroidectomy (TT) is a feasible novel surgical procedure that does not need visible incisions, a truly cutaneous scar-free surgery. Inclusion criteria are (a) patients who have a ultrasonographically (US) 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, and (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 a 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 medial edges. TT is done fully endoscopically using conventional endoscopic instruments.

 

Transoral tiroidektomi (TT) görünür insizyonlar gerektirmeyen ve gerçekten ciltte skar bırakmadan uygulanabilen yeni bir cerrahi girişimdir. Uygulama kriterleri a) ultrasonografi (USG) ile tahmini tiroid çapı 10 cm'den fazla olmayan hastalar, (b) USG ile tahmini gland hacminin ≤45 mL olması, (c) nodül çapının ≤50 mm olması, (d) tiroid kisti, tek nodüler guatr veya multinodüler guatr gibi benign kitleler, (e) foliküler neoplazm ve (f) metastaz kanıtı olmayan papiller mikrokarsinom. Girişim, oral vestibülden üç port tekniği ile; biri 30° endoskop için 10 mm'lik port ve diseksiyon ve koagülasyon aletleri için iki ek 5 mm’lik port ile gerçekleştirilir. CO2 insüflasyon basıncı 6 mm Hg'de ayarlanır. Oral vestibülden inferiorda sternal çentiğe, yanlarda ise sternokleidomastoid kasların medial kenarlarına kadar anterior servikal subplatizmal boşluk oluşturulur. TT bildik endoskopik aletler kullanılarak tamamen endoskopik olarak gerçekleştirilir.

 

 

Cite this article as: Fama F, Zhang D, Pontin A, Makay Ö, Tufano RP, Kim HY, et al. Patient and Surgeon Candidacy for Transoral Endoscopic Thyroid Surgery. Turk Arch Otorhinolaryngol 2019; 57(2): 105-8.

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