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Novel suspension system for gasless transoral vestibular thyroidectomy

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Abstract

Background

The transoral endoscopic thyroidectomy vestibular approach (TOETVA) is receiving increased attention, frequently due to growing requirements for cosmetic incisions. Here, we report our initial experience and discuss the safety and efficacy of the innovative surgical working space suspension system for gasless TOETVA.

Methods

We retrospectively analyzed 75 consecutive patients for whom gasless TOETVA with our novel working space suspension system was used. This suspension system included self-developed retractors, a sterile bandage, and an anesthesia stand. We also improved some main surgical instruments in gasless TOETVA.

Results

The study included 75 patients who successfully underwent thyroidectomy and central neck dissection via gasless TOETVA. The mean operating time was 143.27 ± 34.60 min. The mean number of retrieved lymph nodes was 8.00 ± 5.39. Conversion to open surgery did not occur, nor did patients exhibit serious postoperative complications. Postoperative complications included 4 cases of transient recurrent laryngeal nerve (RLN) palsy, 9 of transient hypoparathyroidism, and 3 of transient mental nerve injury. One patient with subcutaneous fluid after surgery recovered after aspiration. Another patient with submental minor perforation recovered well after suturing. There was no evidence of specific complications related to self-designed retractors.

Conclusion

The innovative working space suspension system for gasless TOETVA provided enough and stable working space and optimized the clarity of the surgical field without CO2-related complications.

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Author notes

  1. Jinxi Jiang and Gaofei He have contributed equally to this manuscript.

Authors and Affiliations

  1. Department of Head and Neck Surgery, Sir Run Run Shaw Hospital, Medical School, Zhejiang University, Hangzhou, People’s Republic of China

    Jinxi Jiang, Gaofei He, Junjie Chu, Jianbo Li, Xiaoxiao Lu & Deguang Zhang

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  1. Jinxi Jiang
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  2. Gaofei He
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  3. Junjie Chu
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  4. Jianbo Li
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  5. Xiaoxiao Lu
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  6. Deguang Zhang
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Correspondence to Deguang Zhang.

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Jinxi Jiang, Gaofei He, Junjie Chu, Jianbo Li, Xiaoxiao Lu, and Deguang Zhang have no conflicts of interest or financial ties to disclose.

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Jiang, J., He, G., Chu, J. et al. Novel suspension system for gasless transoral vestibular thyroidectomy. Surg Endosc 37, 1070–1076 (2023). https://doi.org/10.1007/s00464-022-09528-9

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