[SCAR FREE THYROIDECTOMY AND PARATHYROIDECTOMY USING TRANSORAL ENDOSCOPIC VESTIBULAR APPROACH - THE FIRST 100 PATIENTS CASE SERIES IN ISRAEL].

Introduction: The use of transoral endoscopic vestibular approach for thyroidectomy (TOETVA) and parathyroid (TOEPVA) has been increasing worldwide, including in Israel.

Aims: To describe a single institute experience of the first 100 patients undergoing TOETVA or TOEPVA.

Methods: A prospective study of all patients undergoing TOETVA or TOEPVA. Outcomes were defined as the ability to complete surgery endoscopically (success rate), safety profile and length of operation.

Results: A total of 100 patients were included; 81 (81%) underwent TOETVA and the remaining (19%) TOEPVA. Of 81 TOETVA patients, 73 (90.1%) underwent hemithyroidectomy. The success rate was 98.8% (80/81). Six temporary recurrent laryngeal injuries (6.7% of nerves at risk) were documented. No permanent complication was documented, including hypocalcemia. Mean length of operation (hemithyroidectomy) was 2.6±0.9 hours. The removal of thyroid cancer using TOETVA was performed in 51 patients (63%). All tumors were resected with clean margins. Parathyroid adenoma was located in 94.7% of the patients undergoing TOEPVA (18/19). All surgeries were completed endoscopically, without complications. Calcium levels normalized in 100% of the patients following surgery.