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Surgical Equipment, Supplies, and Setup for Transoral Thyroid and Parathyroid Surgery via the Vestibular Approach

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Transoral Neck Surgery

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Abstract

Transoral thyroid and parathyroid surgery is made possible with the use of endoscopic and robotic technology through a novel, scarless approach in the lower vestibulum of the oral cavity (lower lip). The evolution of thyroid surgery from a large incision in the neck to remote-access, scarless approaches has in large part been made possible by advancements in laparoscopic and robotic technology, devices, and accessories. While these tools have been used for remote-access thyroid surgery from various approaches from the chest, axilla, and neck areas, there are unique challenges with the transoral approach that require familiarity with the requisite instrumentation. In this chapter, we highlight pre- and postoperative aspects of transoral endoscopic thyroidectomy vestibular approach (TOETVA) in patient management, operative room setup, and instrumentation. As with any new procedure, proper instrumentation and familiarity with all elements of the operation are of paramount importance.

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Authors and Affiliations

  1. Department of Surgery, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea

    Young Jun Chai

  2. Division of Endocrine Surgery, Ege University Hospital, Bornova, Izmir, Turkey

    Özer Makay

  3. Department of Otorhinolaryngology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University Hospital, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Che-Wei Wu

  4. Department of Surgery, Korea University College of Medicine, Seoul, South Korea

    Hoon Yub Kim

  5. Korea University Hospital, Seoul, South Korea

    Hoon Yub Kim

  6. Division of Endocrine and Minimally Invasive Surgery, University of Messina, Varese, Italy

    Gianlorenzo Dionigi

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  1. Young Jun Chai
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  2. Özer Makay
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Correspondence to Gianlorenzo Dionigi .

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Editors and Affiliations

  1. Otolaryngology – Head and Neck Surgery, Johns Hopkins Medicine Otolaryngology – Head and Neck Surgery, Baltimore, MD, USA

    Jonathon O. Russell

  2. Department of Surgery, University of Kentucky, Lexington, KY, USA

    William B. Inabnet III

  3. Otolaryngology – Head and Neck Surgery, Johns Hopkins Medicine Otolaryngology – Head and Neck Surgery, Baltimore, MD, USA

    Ralph P. Tufano

Electronic Supplementary Material

Insertion of Veress needle to inject epinephrine-saline solution (MP4 11774 kb)

Insertion of mosquito and Kelly clamps to create working space (MP4 27912 kb)

Insertion of vascular tunneler deep to the sternal notch to create working space (MP4 17129 kb)

Dissection of soft tissue to identify the left recurrent laryngeal nerve at the entry point using dissector. The left thyroid gland is hold upward (MP4 7440 kb)

Putting the specimen into the plastic bag. The bag is introduced and pulled out through the midline trocar (MP4 18317 kb)

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Chai, Y.J., Makay, Ö., Wu, CW., Kim, H.Y., Dionigi, G. (2020). Surgical Equipment, Supplies, and Setup for Transoral Thyroid and Parathyroid Surgery via the Vestibular Approach. In: Russell, J., Inabnet III, W., Tufano, R. (eds) Transoral Neck Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-30722-6_7

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