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Gland Surg. 2017 Jun;6(3):277-284. doi: 10.21037/gs.2017.03.16.

Transoral endoscopic thyroidectomy using vestibular approach: updates and evidences.

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Department of Surgery, Minimally Invasive and Endocrine Surgery Division, Police General Hospital, Bangkok, Thailand.
Department of Surgery, KUMC Thyroid Center, Korea University College of Medicine, Seoul, Korea.
Department of Surgical Sciences and Human Morphology, 1st Division of Surgery, Research Center for Endocrine Surgery, University of Insubria (Como-Varese), Varese, Italy.


Recently, natural orifice transluminal endoscopic surgery (NOTES) has been applied in thyroid surgery with transoral access. The benefit of transoral endoscopic thyroidectomy is the potential for scar-free surgery. However, there are many concerns over some aspects, such as infection, recurrent laryngeal nerve injury, and oncological outcome. In this paper, we have reviewed the development history and the current clinical evidence of this innovative surgery. We conclude that the transoral endoscopic thyroidectomy vestibular approach (TOETVA) is feasible and can be considered no longer an experimental operation.


Transoral endoscopic thyroidectomy; endoscopic thyroidectomy; natural orifice transluminal endoscopic surgery (NOTES); thyroidectomy; transoral; transoral endoscopic thyroidectomy vestibular approach (TOETVA)

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Conflicts of Interest: The authors have no conflicts of interest to declare.

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