Lessons Learned from the Transoral Endoscopic Thyroidectomy with Vestibular Approach (TOETVA) for the Treatment of Thyroid Carcinoma.

Background: Early detection of thyroid carcinoma has become commonplace. Consequently, the endoscopic approach has become a widely used method.

Objective: Our aim was to report our experience with the transoral endoscopic thyroidectomy vestibular approach (TOETVA).

Methods: We reviewed the records of 46 patients who underwent TOETVA. Only patients with no regional lymph node metastases (N0) and fine needle aspiration biopsy-confirmed thyroid cancer were included. The surgical technique used was as described by Angkoon Anuwong.

Results: Forty-six patients with a mean age of 43.6 years (range 17-71) were included (37 women and 9 men). The mean time of surgery was 207 min (range 95-345), and the conversion to open thyroidectomy rate was 13% (six cases).

Conclusion: TOETVA is an acceptable approach for thyroid carcinoma. Poorly differentiated cancer, as well as extrathyroidal extension, result in patients being unsuitable for TOETVA. It is imperative to identify the circumstances under which conversion to open thyroidectomy must take place.