Transoral thyroidectomy and parathyroidectomy - A North American series of robotic and endoscopic transoral approaches to the central neck

- Transoral thyroidectomy via a vestibular approach is an option for patients who are motivated to avoid a neck scar.
- This approach does not appear to be limited by increased body mass index.
- Advantages include limited dissection, midline access to both thyroid lobes and safe same-day discharge.

ObjectiveMost thyroid surgery in North America is completed via a cervical incision, which leaves a permanent scar. Approaches without cutaneous incisions offer aesthetic advantages. This series represents the largest series of transoral vestibular approaches to the central neck in North America, and the first published reports of robotic transoral vestibular thyroidectomy for thyroid carcinoma.Materials and methodsData was prospectively collected for patients that underwent transoral vestibular approach thyroidectomy and/or parathyroidectomy between April 2016 and February 2017.ResultsFifteen patients underwent the procedure for removal of the thyroid (n = 12), parathyroid (n = 2) or both thyroid and parathyroid glands (n = 1). The first case was converted to an open procedure. Fourteen were completed through these remote access incisions, including patients with a body mass index as high as 44. There were no permanent complications. The postoperative median Dermatology Life Quality Index score was 3, which indicates a small effect on quality of life.ConclusionThe transoral vestibular approach to the central neck is a promising technique for patients who desire to optimize aesthetics.