Natural Orifice Total Transtracheal Endoscopic Thyroidectomy Surgery: First Reported Experiment.

Background: Natural orifice translumenal endoscopic surgery (NOTES(®); American Society for Gastrointestinal Endoscopy [Oak Brook, IL] and Society of American Gastrointestinal and Endoscopic Surgeons [Los Angeles, CA]) is an improvement in surgical interventions. In this study we developed an innovative transtracheal endoscopic thyroidectomy technique and explored its feasibility in animal models.

Materials And Methods: Transtracheal endoscopic thyroidectomy was performed in anesthetized dogs and pigs. The endoscope was advanced into the pretracheal space via a longitudinal incision on the anterior tracheal wall. Hemithyroidectomies and partial lobectomy were performed using special double-lumen endotracheal tubes and conventional endoscopic instruments. The tracheal wall incision was closed using absorbable sutures, and the animals were sacrificed at Day 5 postsurgery.

Results: Hemithyroidectomy and partial thyroidectomy were successfully performed on pigs and dogs. The average operative time for each model was 69.4 minutes. No significant complications were encountered during surgery.

Conclusions: The transtracheal endoscopic thyroidectomy technique is feasible and has the potential to be an alternative method for other types of thyroid surgeries.