The transoral thyroidectomy (TT) is a feasible novel surgical procedure that does not need visible incisions, a truly cutaneous scar-free surgery. Inclusion criteria are (a) patients who have a ultrasonographically (US) estimated thyroid diameter not larger than 10 cm, (b) US estimated gland volume <= 45 mL, (c) nodule size <= 50 mm, (d) a benign tumor, such as a thyroid cyst, single-nodular goiter, or multinodular goiter, (e) follicular neoplasm, and (f) papillary microcarcinoma without evidence of metastasis. The procedure is carried out through a three-port technique placed at the oral vestibule; one 10-mm port for a 30 degrees endoscope and two additional 5-mm ports for dissecting and coagulating instruments. CO2 insufflation pressure is set at 6 mmHg. An anterior cervical subplatysmal space is created from the oral vestibule down to the sternal notch, laterally to the sternocleidomastoid muscle medial edges. TT is done fully endoscopically using conventional endoscopic instruments.
[1]Univ Messina, Univ Hosp G Martino, Dept Human Pathol Adulthood & Childhood G Barresi, Div Endocrine & Minimally Invas Surg, Messina, Italy.
[2]Jilin Univ, Jilin Prov Precis Med Lab Mol Biol & Translat Med, Jilin Prov Key Lab Surg Translat Med, Div Thyroid Surg China Japan Union Hosp, Jilin, Jilin, Peoples R China.
[3]Ege Univ, Sch Med, Dept Gen Surg, Izmir, Turkey.
[4]Johns Hopkins Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, Baltimore, MD 21205 USA.
[5]Korea Univ, Korea Univ Hosp, Coll Med, Dept Surg,KUMC Thyroid Ctr, Seoul, South Korea.
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