Modified equipment for facilitating the transoral vestibular approach to endoscopic thyroidectomy
Piyapong Bamroong1, Pornthep Kasemsiri2, Cattleya Thongrong3, Kanokkarn Mahawerawat1, Siriwan Tongwiset1, Angkana Rachain1, Sirikarn Khaengraeng1
1 Department of Otorhinolaryngology, Mukdahan Hospital, Mukdahan, Thailand
2 Department of Otorhinolaryngology, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University; Khon Kaen Head and Neck Oncology Research; Srinagarind Minimally Invasive Surgery Center of Excellence, Khon Kaen, Thailand
3 Department of Anesthesiology, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University; Khon Kaen Head and Neck Oncology Research, Khon Kaen, Thailand
Department of Otorhinolaryngology, Skull Base Surgery Unit, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen 40002
Source of Support: None, Conflict of Interest: None
Objectives: The objectives of the study were to investigate the improvement in operation time for thyroid surgery gained using a modified endobag and suture and to accelerate the learning process for novice endoscopic surgeons.
Materials and Methods: A retrospective study was conducted between 2 June 2015 and 1 November 2018. Medical records of patients who underwent transoral endoscopic thyroidectomy vestibular approach (TOETVA) were retrieved and analysed. Comparisons of operative time with or without the use of modified equipment were calculated by the unequal variance t-test in lobectomy and isthmectomy groups.
Results: Medical records of 102 patients (mean age: 39.1 years) were analysed. The size of thyroid nodule averaged 4.0 cm (range: 1.0–13.0 cm). TOETVA was applied for right lobectomy (57.8%), left lobectomy (34.3%), isthmectomy (3.9%) and total thyroidectomy (3.9%). Early in our experience, TOETVA required 168 min, whereas following the introduction of the modified endobag and extracorporeal suture, operative time was reduced to 30 min (P > 0.05).
Conclusions: The use of modified equipment permitted shorter operation times. The time difference was not statistically significant but does represent a significant time-saving. The use of the modified equipment will simplify and speed up the learning process for novice endoscopic surgeons.