Transoral endoscopic parathyroidectomy vestibular approach: a novel scarless parathyroid surgery

2016 ◽  
Vol 31 (9) ◽  
pp. 3755-3763 ◽  
Author(s):  
Thanyawat Sasanakietkul ◽  
Pornpeera Jitpratoom ◽  
Angkoon Anuwong
Keyword(s):  
Parathyroid Surgery ◽  
Vestibular Approach ◽  
Endoscopic Parathyroidectomy

A Single Surgeon’s 10-Year Experience in Remote-Access Thyroid and Parathyroid Surgery

2020 ◽  
pp. 000313482095030
Author(s):  
Emad Kandil ◽  
Mounika Akkera ◽  
Hosam Shalaby ◽  
Ruhul Munshi ◽  
Abdallah Attia ◽  
...  
Keyword(s):  
Learning Curve ◽  
Evoked Potential ◽  
Operative Time ◽  
Endoscopic Thyroidectomy ◽  
Remote Access ◽  
Parathyroid Surgery ◽  
American Institute ◽  
Effective Learning ◽  
Select Group ◽  
Vestibular Approach

Background Remote-access thyroid and parathyroid surgery has gained popularity recently due to its benefit of avoiding visible neck scars. Most of these techniques were described and performed in Asia, on patients with different body habitus compared to American patients. We aim to analyze the learning curve in performing these operations in North America.  Methods This is a retrospective cohort study of a 10-year experience by a single surgeon at a North American institute. Patients who underwent thyroid or parathyroid procedures by a transaxillary, retroauricular, or transoral endoscopic thyroidectomy vestibular approach (TOETVA) were included. Cumulative sum (CUSUM) was used to analyze learning curves based on intraoperative blood loss and total operative times and learning phases were divided accordingly. Results Three hundred seventy-two remote-access thyroid and parathyroid procedures were performed during the study period. Total operative time for transaxillary procedures was initially reduced after the 69th procedure and then again after the 134th case. For retroauricular procedures, marked reduction in the operative time was observed after 21 procedures. Most patients (57.02%) were discharged home on the same day during the mastering phase. In the transaxillary procedures, only 1 case of brachial plexus injury occurred prior to the routine use of somatosensory evoked potential (SSEP) monitoring. Discussion Remote-access thyroid and parathyroid surgeries can be performed safely with minimal complications in a select group of patients. Analysis of the learning curve in performing these operations aids in structuring a safe and effective learning period for endocrine surgeons seeking to venture into this modality of treatment.

scholarly journals Anesthesia for Transoral Endoscopic Parathyroidectomy by Vestibular Approach (TOEPVA)

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Fulya YILMAZ ◽  
Koray BAS
Keyword(s):  
Demographic Data ◽  
Surgical Techniques ◽  
Hemodynamic Parameters ◽  
Safe Anesthesia ◽  
Close Cooperation ◽  
Improve Patient Management ◽  
Conventional Open Surgery ◽  
Vestibular Approach ◽  
Improve Patient ◽  
Endoscopic Parathyroidectomy

Abstract Background After thyroid diseases, hyperparathyroidism is one of the most common endocrine surgical diseases. The increasing diagnosis of thyroid pathologies in early stages and a societal emphasis on physical appearances, especially in young women, have led to the development of new surgical techniques alternative to conventional transcervical incision consistently. Here, we describe our anesthesia experience for parathyroidectomy with Transoral Endoscopic Parathyroidectomy by Vestibular Approach (TOEPVA). Patients who undergo TOEPVA at our institution between November 2018 and April 2019 were reviewed. Demographic data and hemodynamic parameters were reported. Results Seven patients were operated successfully by this technique, none of which required conversion to conventional open surgery. Two patients required atropine and one patient required ephedrine during insufflation. Conclusion After induction of anesthesia with propofol, remifentanil, and rocuronium and anesthesia managed by desflurane co-administered with continuous infusion of remifentanil provide feasible and safe anesthesia for TOEPVA. However, especially during hydrodissection and insufflation, a close cooperation between surgeon and anesthetist has a great value to improve patient management.

Transoral Endoscopic Parathyroidectomy Vestibular Approach (TOEPVA)—Choosing the Right Patient

2019 ◽  
Vol 7 (3) ◽  
pp. 232-236
Author(s):  
Rohit Ranganath ◽  
Jonathon O. Russell ◽  
Vaninder K. Dhillon ◽  
Ralph P. Tufano
Keyword(s):  
The Right ◽  
Vestibular Approach ◽  
Endoscopic Parathyroidectomy

scholarly journals Transoral thyroid and parathyroid surgery via the vestibular approach—a 2020 update

Gland Surgery ◽  
2020 ◽  
Vol 9 (2) ◽  
pp. 409-416 ◽  
Author(s):  
Jonathon O. Russell ◽  
Zeyad T. Sahli ◽  
Mohammad Shaear ◽  
Christopher Razavi ◽  
Khalid Ali ◽  
...  
Keyword(s):  
Parathyroid Surgery ◽  
Vestibular Approach

Transient asystole related to carbon dioxide embolism during transoral endoscopic parathyroidectomy vestibular approach

Head & Neck ◽  
2021 ◽  
Vol 43 (11) ◽  
Author(s):  
Nurcihan Aygun ◽  
Demet Sarıdemir ◽  
Koray Bas ◽  
Fatih Tunca ◽  
Cumhur Arici ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Carbon Dioxide Embolism ◽  
Vestibular Approach ◽  
Dioxide Embolism ◽  
Endoscopic Parathyroidectomy

Transoral endoscopic parathyroidectomy vestibular approach: A systematic review

2021 ◽  
Vol 42 (1) ◽  
pp. 102810
Author(s):  
Payam Entezami ◽  
Lindsay Boven ◽  
Erin Ware ◽  
Brent A. Chang
Keyword(s):  
Systematic Review ◽  
Vestibular Approach ◽  
Endoscopic Parathyroidectomy

scholarly journals Remote access endoscopic parathyroidectomy: a study of 17 cases from Central India

2021 ◽  
Vol 7 (4) ◽  
pp. 657
Author(s):  
Raj Narendra Gajbhiye ◽  
Gayatri Amit Deshpande ◽  
Bhupesh Tirpude ◽  
Hemant Bhanarkar ◽  
Vikrant Akulwar ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Central India ◽  
Remote Access ◽  
Patient Comfort ◽  
Endoscopic Techniques ◽  
Nerve Paresis ◽  
The Mean ◽  
Parathyroid Tumours ◽  
Vestibular Approach ◽  
Endoscopic Parathyroidectomy

<p><strong>Background: </strong>It has been debated that "remote access endoscopic parathyroidectomy" requires extensive dissection, thereby, increasing the risk of complications. Hence, the aim of this study is to assess the feasibility and safety of remote access endoscopic parathyroidectomy via the unilateral axilla-breast approach (ABA) and transoral vestibular approach (TOEPVA).  </p><p><strong>Method: </strong>The study includes 17 patients with primary hyperparathyroidism undergoing endoscopic parathyroidectomy from January 2016 to December 2020. Of these, 11 patients underwent parathyroidectomy via unilateral ABA and 6 had TOEPVA. Preoperatively, ultrasonography of neck, sestamibi scan and CT scan neck were done to localise the diseased gland. Post operatively, Serum calcium and parathyroid hormone levels were monitored.</p><p><strong>Results</strong>: The mean age of patients was 35.6±10.5 years. Except one, all the patients were females. The mean operative time of the unilateral ABA and TOEPVA group was 93.67±28.64 minutes and 138.6±31 minutes respectively. Except for three patients, in all the patients, the parathormone levels normalised. One patient had hungry bone syndrome postoperatively. The mean hospital stay of the unilateral ABA and TOEPVA group was 3±1.5 days and 4±3.09 days respectively. One patient had post-operative transient recurrent laryngeal nerve paresis. Seroma and surgical emphysema were seen in two patients each. </p><p><strong>Conclusions</strong>: Remote Access Endoscopic parathyroidectomy may be considered safe in treatment of parathyroid tumours. Precise preoperative localisation is mandatory. In addition to a magnified view and a better illumination, the potential advantages of endoscopic techniques are better cosmetic results, decreased hospital stay and better patient comfort.</p>

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