Gland and Hormone Related Diseases

All Conditions

Neoplasms

Thyroid Diseases

Thyroid Nodule

Endocrine System Diseases

Thyroid Neoplasms

Endocrine Gland Neoplasms

Head and Neck Neoplasms

a new approach in surgery which can treat the thyroid disease

TOVETA is a new approach in surgery of thyroidectomy no longer open on the neck

Transoral endoscopic thyroidectomy vestibular approach

Hung Hin, Brian Lang, MBBS(Hons)

Thyroid surgery has been developed as a new technique for zero scar in surgery by applying transoral endoscopic thyroidectomy with sublingual approach. The new technique is locating the surgery which pierced through floor of mouth, cause severe tissue damage, high complication, and conversion rates to open surgery and surgical difficulties due to limitation of movement. Nevertheless, each report is still including small number of patients. Recently, the transoral endoscopic thyroidectomy vestibular approach (TOETVA) has been proven feasible and safe in several overseas centers. Moreover, a successful TOETVA case was reported in local media in the late last year. Hence, this study is for evaluating the feasibility and safety of the TOETVA prospectively at a tertiary referral center in Hong Kong.

The following are the procedure of the study:

1. Recruit patients from the clinic.
2. Patients will receive treatment within 3 months
3. Patients will have different assessments like Ultrasonography assessment, Fine needle biopsy, Direct laryngoscopy, and Cosmectic scoring in Pre-operation, post-operation 2 week, post 1 month, post 3 month, post 6 month and post 12 month.
4. Patients will be monitoring by the same team after the study.

The Feasibility and Safety of the TOETVA for Benign Thyroid Nodules

A Prospective Evaluation of the Feasibility and Safety of the Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) as a Treatment for Benign Thyroid Nodules

To record any complication of surgery in every post-operation visit after 12 months. The record will be used for the calculation of complication rate.

To record any cases which need to apply open surgery necessary during the procedure of TOETVA

To record the situation of wound infection after surgery

To record the situation of hematoma after surgery

To calculate the vocal cord situation after surgery within 12 months

To record the thyroid function from blood test in 12 months after surgery and calculate the rate of hypo-parathyroid function

The pain scoring with 0-10 to assess the pain level of having TOETVA

The satisfaction in 0-10 scoring after the surgery

The University of Hong Kong

Clinical Associate Professor

Rare Diseases

Carcinoma

Thyroid Cancer, Papillary

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

Adenocarcinoma

Adenocarcinoma, Papillary

Papillary Thyroid Carcinoma

Anti-Infective Agents

All Drugs and Chemicals

Blood Substitutes

Micronutrients

Povidone-Iodine

Povidone

Iodine

Cadexomer iodine

Parathyroid Hormone

Patients in the retro-auricular single-site endoscopic thyroidectomy (RASSET) group will receive endoscopic thyroid lobectomy and central lymph node dissection.

Patients in the Transoral Endoscopic Thyroidectomy Vestibular Approach group will receive endoscopic thyroid lobectomy and central lymph node dissection.

Patients in the Transareola Endoscopic Thyroidectomy group will receive endoscopic thyroid lobectomy and central lymph node dissection.

The strap muscles and the sternocleidomastoid muscle were separated. Upper parathyroid and lower parathyroid glands were identified and preserved. The recurrent laryngeal nerve (RLN) was identified，A lobe of thyroid specimen and central lymph nodes were dissected.

Retro-Auricular Single-Site Endoscopic Thyroidectomy

The patient was placed in a supine position with slight neck extension under nasotracheal intubation. The mouth was garbled with povidone iodine before surgery. Three laparoscopic ports (a 10- to 15-mm port at midline and two 5-mm ports at the lateral junction between the canine and first premolar teeth)were inserted under the lower lip at the oral vestibular area.The strap muscleswere separated in the midline to expose the thyroid and trachea. The recurrent laryngeal nerve (RLN) was identified at the insertion to the larynx, then followed downandparallel tothe trachea inferiorly.

Transoral Endoscopic Thyroidectomy Vestibular Approach

The patient was in supine position. Incision was made inside the right areola and a 10mm puncture device was placed, subcutaneous separation rod was used to separate the space, and a 30° endoscope was introduced, puncture device was placed in a 5mm incision on the left areola, ultrasonic knife free flap was used, subcutaneous separation space was placed in the upper sternal segment, and a 5mm puncture device was placed outside the right areola. The anterior cervical flap was further dissociated to establish a space. The median cervical line was cut to cut off the isthmus of the thyroid, and the tracheal fascia ligament of the thyroid was separated and the nerve was exposed to protect the nerves. Then remove the lobe of thyroid and central lymph nodes

Transareola Endoscopic Thyroidectomy

Dian Ouyang

The goal of this retrospective study is to compare the safety and efficiacy of endoscopic thyroidectomy via retro-auricular single-site approach, transoral endoscopic thyroidectomy vestibular approach and transareola approach.

Safety of Endoscopic Thyroidectomy Via Retro-Auricular Single-Site Approach, Transoral Approach and Transareola

Single-center, Retrospective Study of Retro-Auricular Single-Site Endoscopic, Transoral Endoscopic Thyroidectomy Vestibular Approach and Transareola Endoscopic Thyroidectomy in Patients With Early Stage Papillary Thyroid Carcinoma

the level of CRP before and after operation

The volume of blood loss during operation

Postoperative specimen Postoperative specimen Postoperative specimen Postoperative specimen the number of lymph nodes in postoperative specimens

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
The Feasibility and Safety of the TOETVA for Benign Thyroid Nodules	NCT03158961	Thyroid Disease...	Transoral endos...	18 Years -	The University of Hong Kong
Safety of Endoscopic Thyroidectomy Via Retro-Auricular Single-Site Approach, Transoral Approach and Transareola	NCT05760690	Papillary Thyro...	Retro-Auricular... Transoral Endos... Transareola End...	18 Years - 70 Years	Sun Yat-sen University
Safety of Endoscopic Thyroidectomy Via Retro-Auricular Single-Site Approach, Transoral Approach and Transareola	NCT05760690	Papillary Thyro...	Retro-Auricular... Transoral Endos... Transareola End...	18 Years - 70 Years	Sun Yat-sen University

Spots Global Cancer Trial Database for transoral endoscopic thyroidectomy vestibular approach