Transoral Endoscopic Thyroidectomy through Vestibular Approach; Report of Initial Experience

Background : Endoscopic thyroidectomy is a minimally invasive approach with a rising popularity due to favorable esthetic outcome. Transoral vestibular approach endoscopic thyroidectomy (TOVET) was progressively adopted for many thyroid pathologies. We, herein report our initial experience utilizing TOVET for benign thyroid lesions. Patients and methods : This prospective study was conducted from December 2020 and February 2023, 15 patients with benign thyroid nodules were selected. All patients considered scarless thyroidectomy as their preferred surgical approach and were operated on for TOVET. Clinicopathological data and surgical outcomes were reported. Results : Fifteen patients comprising one male and 14 female underwent TOVET. Of these patients, 12 (80%) patients for thyroid lobectomy, and three (20%) for total thyroidectomy. All thyroidectomies were completed endoscopically except a single case of conversion to open cervical incision. No cervical incision for specimen retrieval after the complete endoscopic dissection. None of the patients was reported with temporary or permanent recurrent laryngeal nerves injury, or postoperative hypocalcemia. We reported two cases of temporary mental nerve numbness, two cases of surgical emphysema, and one cases of fl ap hematoma. Conclusion : TOVET is a feasible and safe procedure, with higher satisfaction after surgery in esthetic, short-term, and long-term outcomes. Tumor size is important in the decision regarding considering the approach.