TOETVA (Transoral Endoscopic Thyroidectomy by Vestibular Approach) and TOEPVA (Transoral Endoscopic Parathyroidectomy by Vestibular Approach): First Cases in Venezuela.

Abstract

Introduction: The open surgical technique for thyroid surgery was described by Kocher in the XIX and has been maintained for more than 100 years. The endoscopic vestibular approach to thyroidectomy and parathyroidectomy, is a novel approach that avoids scar on the neck and offers favorable healing results. It is accepted as an alternative to traditional open cervical approaches. The objective is to present two clinical cases to which endoscopic vestibular approach for thyroidectomy and transoral parathyroidectomy was performed. Clinical Cases: The first was a 42 year old female, with injury between middle third and lower pole of the right thyroid lobe, whose puncture reported thyroid papillary carcinoma. The second case was a 66 year old female, who went with high PTH value (parathormone: 205.91pg/ml), and gammagram, which reported paratyroid adenoma, so it was raised diagnosis of primary hyperparathyroidism. Both were raised endoscopic vestibular transoral approach. CONCLUSIONS: The vestibular approach to transoral endoscopic thyroidectomy and parathyroidectomy, is feasible, effective and safe, also offering the best known cosmetic result. Toetva and Toepva, are challenging surgeries, with a wide and pronounced learning curve, but when performed by expert surgeons, it provides immense benefits for patients from the healing, aesthetic and functional point of view, with the absence of post-surgical drainage, better recovery and less recurrent laryngeal nerve injury due to its best identification.