Background: Natural orifice translumenal endoscopic surgery has been recognized as a scar less surgery. There are several access organs into abdominal cavity such as stomach, rectum, vagina, or bladder. In neck surgery, the routes of endoscopic thyroidectomy are via the chest, breast, axillary or a combined of those. Here we introduced the new access route to thyroid gland to perform thyroidectomy and evaluated the feasibility study of transoral endoscopic thyroidectomy (TET).
Materials and Methods: Between July and September 2009, we performed TET in 2 cadavers and 3 dogs. Initially 5-mm port was inserted into the sublinguales of the mouth floor. Subplatysmal blunt dissection in the neck was done to create working space and insert another two 5-mm ports. After dividing the subplatysmal tissue and strap muscle, thyroid gland was identified on the trachea in cadaver and besides the trachea in dog. Under the guidance of 5 mm rigid endoscope, hemithyroidectomy was performed by dissecting forceps and electrocautery. And then dogs were sacrificed to observe the condition of operative field.
Results: All procedures were successfully performed in cadavers and dogs. There were no particular complications relating TET. The operative field in cadaver was relatively narrow compared with that of dog due to the difficulty of skin stretch. The mean operation time took 50min. In male cadaver, Adam’s apple became an obstacle of manipulation of the endoscope.
Conclusion: TET is a feasible and safe procedure without any particular complications. Although we need a strict observation of the oral condition after TET, this will be an alternative method to conventional thyroidectomy.
Program Number: P241