AB002. 76. First experience of trans oral endoscopic thyroidectomy—vestibular approach (TOETVA) in Ireland & UK at Cork University Hospital

Background: Many patients requiring thyroidectomy are concerned regarding scar caused by incision in the neck. Various techniques of minimally invasive thyroidectomy, including endoscopic and robotic thyroidectomy, have been developed to address this issue. TOETVA has been successfully used in the recent past worldwide, with few complications and excellent results. Moreover, recent literature comparing TOETVA with open thyroidectomy has confirmed that the TOETVA is performed as safely as traditional open thyroidectomy, requires only conventional laparoscopic instruments, and avoids incisional scars; thus, the approach may be an option for selected patients.

Methods: We present a case series of two young female patients presenting with neck lumps and requesting scar less neck surgeries for cosmetic concerns. First lady aged 23 presented with a 3 cm benign left thyroid lobe nodule with cosmetic concerns. Second lady aged 56 presented with a 2.8 cm, indeterminate right thyroid lobe nodule. Both were booked for trans oral hemithyroidectomy (TOETVA) after explaining risks, benefits & alternatives.

Results: Both patients had un-eventful surgeries and were discharged home on day 1 post op. Both had mild post op bruising that settled completely at 2 weeks post op. Second patient had mild paraesthesia at chin at day 1 that settled subsequently at day 7 likely representing neuropraxia. There was no hoarseness of voice or post op hypocalcaemia in either of them. Histology was benign for both patients who were subsequently discharged from clinic at week 4 post op.

Conclusions: TOETVA is a safe alternative minimally invasive procedure for the management of benign & malignant thyroid lesions in suitable patients.

Keywords: Thyroid nodule; TOETVA; trans oral thyroidectomy