Abstract
The aim of this study was to address the first cases of TOETVA done in Brazil, by TOETVA-Bra study group, regarding safety and complications. Series of the first 93 TOETVAs cases in Brazil. All authors except LPK, AJG JOR and RPT received TOETVA training including cadaveric hands-on in Thailand or United States (Johns Hopkins Medicine) during 2017. After they came back to Brazil and started doing their first TOETVA cases in the cities of Rio de Janeiro, Sao Paulo and Chapecó they agreed to collaborate and gather data using an online spreadsheet. All patients were submitted to the technique described by Anuwong. A total of 93 patients underwent TOETVA. Most patients (58.1%) were submitted to total thyroidectomy and 59.1% had benign disease. Two patients (2.2%) needed conversion to open surgery. Five patients (9.3%) developed transient hypoparathyroidism and there were 3 (2.0%) temporary recurrent laryngeal nerve palsy. There was one (0.7%) permanent unilateral palsy. Twenty patients had some sort of complication, 16.1% were minor and 5.4% were major. A total of 73 patients (78.5%) had an uneventful recovery. The technique is reproducible with a low complication rate. While further studies are needed to confirm equivalency, early efforts suggest that TOETVA is not inferior to traditional open thyroidectomy in appropriately selected patients.
Highlights
This decade has brought many modifications to the standard open thyroid surgery technique [1]
From the beginning of remote access thyroidectomy, when the techniques focused on hiding the scar in more discrete locations [2,3,4], until now, scarless thyroid and central neck surgery has evolved and may be safely completed via the transoral vestibular approach [1,5,6,7,8]
The Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) is the first remote access technique of thyroid surgery to become widely popular in the Western Hemisphere [9,10,11,12,13]
Summary
This decade has brought many modifications to the standard open thyroid surgery technique [1]. The Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) is the first remote access technique of thyroid surgery to become widely popular in the Western Hemisphere [9,10,11,12,13] Before this procedure, a few surgeons were performing other minimally invasive. TOETVA in Brazil: Safety and complications techniques such as minimally invasive video-assisted thyroidectomy (MIVAT) or axillary, breast or postauricular approaches, but without reproducible results [2,3,14] These techniques were not widely adopted for a number of reasons [15]. The aim of this study was to address the first cases of TOETVA performed in Brazil, by TOETVA-Bra study group, with a specific focus on safety and outcomes of adoption in high volume centers
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