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Transoral thyroidectomy: advantages and limitations

  • Opinion
  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

Abstract

In this opinion paper of the Journal of Endocrinological Investigation, leading experts in the field report on their current clinical experience with a novel approach for thyroid gland surgery, namely, “transoral thyroidectomy” (TOT). This feasible and novel surgical procedure does not require visible incisions and is, therefore, a truly scarless surgery. Patients meeting the following criteria can be considered as candidates for TOT: (a) an ultrasonographically (US) estimated thyroid diameter ≤10 cm; (b) US-estimated gland volume ≤45 mL; (c) nodule size ≤50 mm; (d) presence of a benign tumor such as a thyroid cyst or a single- or multi-nodular goiter; (e) Bethesda 3 and/or 4 category and (f) papillary microcarcinoma without the evidence of metastasis. The procedure is conducted via a three-port technique at the oral vestibule using a 10-mm port for the 30° endoscope and two additional 5-mm ports for the dissecting and coagulating instruments. TOT is performed using conventional endoscopic instruments and is probably the best scarless approach to the thyroid because of the short distance between the thyroid and the incisions placed intra-orally that do not result in any cutaneous scar and upon following the surgical planes. Experts in TOT organized a working group of general, endocrine, head and neck ENT surgeons and endocrinologist to develop the standards for practicing this emerging technique.

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Author information

Authors and Affiliations

  1. 1st Division of General Surgery, Department of Surgical Sciences and Human Morphology, Research Center for Endocrine Surgery, University of Insubria (Varese-Como), via Guicciardini, 9, 21100, Varese, Italy

    G. Dionigi

  2. Division of Head and Neck Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    R. P. Tufano & J. Russell

  3. Division of Breast and Endocrine Surgery, Department of Surgery, Minimally Invasive Surgery and Robotic Surgery Center, KUMC Thyroid Center Korea University, Anam Hospital, Seoul, 08308, Korea

    H. Y. Kim

  4. Endocrine Unit, Department of Medicine and Surgery, University of Insubria, ASST dei Sette Laghi, Viale Borri, 57, 21100, Varese, Italy

    E. Piantanida

  5. Minimally Invasive and Endocrine Division, Department of Surgery, Police General Hospital, Bangkok, Thailand

    A. Anuwong

Authors
  1. G. Dionigi
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  2. R. P. Tufano
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  3. J. Russell
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  4. H. Y. Kim
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  5. E. Piantanida
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  6. A. Anuwong
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Contributions

(I) Conception and design: Gianlorenzo Dionigi, Hoon Yub Kim, Angkoon Anuwong; (II) Administrative support: Gianlorenzo Dionigi, Ralph P. Tufano, Angkoon Anuwong; (IV) Collection and assembly of data: Gianlorenzo Dionigi, Hoon Yub Kim, Ralph P. Tufano; (V) Data analysis and interpretation: Gianlorenzo Dionigi, Hoon Yub Kim, Ralph P. Tufano, Angkoon Anuwong; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

Corresponding author

Correspondence to H. Y. Kim.

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Conflict of interest

The authors have no conflict of interest to disclosure, and no other funding or financial relationship with the surgical industry.

Ethical approval

The study was approved by the institutional ethics committee of Department of Medicine and Surgery, University of Insubria.

Informed consent

All patients were provided the particular details for their surgeries and informed consent obtained from each patient.

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Dionigi, G., Tufano, R.P., Russell, J. et al. Transoral thyroidectomy: advantages and limitations. J Endocrinol Invest 40, 1259–1263 (2017). https://doi.org/10.1007/s40618-017-0676-0

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  • DOI: https://doi.org/10.1007/s40618-017-0676-0

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