Advances in Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA)

Abstract The transoral endoscopic thyroidectomy vestibular approach (TOETVA) has evolved from a novel technique to a legitimate alternative to the traditional open thyroidectomy. The main benefit to remote access thyroid surgery is the ability to deliver a surgery that minimizes the cosmetic and quality of life burden of a visible scar. Among the “scarless” surgical techniques, the transoral endoscopic thyroidectomy is the latest and most ideal minimally invasive approach. Studies have proven its safety and efficacy, compared to standards set by open surgery. There have been no uniform indications or contraindications established for TOETVA, but we have set forth recommendations that determine whether individual patients have “favorable features” for this technique to assess feasibility of the procedure. Similarly, patients who have characteristics where there might be contraindications would be considered by us to have “nonfavorable features” for a transoral endoscopic thyroidectomy. There is potential for widespread applicability, especially when the safety and outcomes are equal to the current gold standard, and patients are presented the option of a cosmetically appealing scarless surgery.