Autres domaines


Trans oral endoscopic thyroidectomy (TOETVA): First French experience in 90 patients - 06/04/21

Doi : 10.1016/j.jviscsurg.2021.02.001 
G. Deroide a, b, , I. Honigman c, A. Berthe b, F. Branger a, b, C. Cussac-Pillegand a, H. Richa a, A. Anuwong d
a Franco-British Hospital Institute, 4, Rue Kleber Hôpital Franco-Britannique, 92300 Levallois, France 
b Clinique Lambert Ramsay, La garenne Colombes, France 
c Polyclinique de Saint-Jean-de-Luz, Saint-Jean-de-Luz, France 
d Police General Hospital, Bangkok, Thailand 

Corresponding author at: Franco-British Hospital Institute, 4, Rue Kleber Hôpital Franco-Britannique, 92300 Levallois, France.Franco-British Hospital Institute4, Rue Kleber Hôpital Franco-BritanniqueLevallois92300France

Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
El acceso al texto completo de este artículo requiere una suscripción.

páginas 8
Iconografías 4
Vídeos 0
Otros 0



Thyroidectomy techniques using extracervical approaches have grown in popularity for about 20 years and their feasibility has now been demonstrated. We wanted to evaluate one of these new approaches: the anterior vestibular endoscopic approach (TOETVA). The aim of this study was to evaluate the results of an initial series patients who underwent an anterior trans-vestibular endoscopic oral thyroidectomy.


From February 2018 to September 2020, this technique was offered to patients aged 18 to 70, ASA I or II, who presented with an indication for thyroid surgery and who wished to avoid cervical scars. The approach was through the anterior vestibule of the mouth and the specimen was extracted either transorally or via the axilla depending on its size. Apart from the first ten cases, all patients underwent recurrent nerve neuromonitoring. The patients were operated on by two surgeons experienced in thyroid surgery. All the patients had follow-up visits on D15, D30 and at 2 months. The pre- and intra-operative data, length of stay and complications were evaluated.


A total of 90 consecutive patients (87 women) aged 46±12.4 years (18 to 69) with a mean BMI of 24.4±4 were included. The indications for surgery included 11 papillary cancers, 5 oncocytic nodules, 15 toxic nodules, 13 cases of Graves disease and 46 symptomatic goiters and/or nodules. The mean pre-operative diameter of the nodules was 3.61±1.99 (0.44 to 7.3) cm. The interventions performed were 44 lobo-isthmectomies, 41 total thyroidectomies and 5 isthmectomies. The mean operating time was 134±45min (40 to 255). On D1, the post-operative ionized calcium was 1.09±0.11mmol/L (4.3685±0.44mg/dL) (normal 0.8–1.15mmol/L) (3.206–4.609mg/dL)) and the total serum calcium was 2.07±0.11mmol/L 8.296±0.44mg/dL (normal 2.2–2.5mmol/L) (8.817–10.019mg/dL). Five patients underwent conversion from endoscopic to open cervical approach (5.5%). The complications were seven cases of transient recurrent nerve palsy (7.8%), eight cases of hypoparathyroidism (19%) including six transient and two permanent, one skin burn and 26 cases of transient chin numbness related to the electrocautery (29%). Ten patients (11%) presented with transient post-operative skin ecchymosis that resolved within 7–10 days. A spontaneous pneumo-mediastinum was observed on chest CT in three patients and evolved favorably. No hematoma, or surgical site infection, or complications related to axillary extraction were observed. All the patients declared themselves satisfied post-operatively and at the end of the follow-up.


The TOETVA route of entry is a safe and reliable technique in well-selected patients wishing to avoid a cervical scar.

El texto completo de este artículo está disponible en PDF.

Keywords : TOETVA, Thyroidectomy, Minimally invasive surgery, Endoscopic surgery


© 2021  Elsevier Masson SAS. Reservados todos los derechos.
Añadir a mi biblioteca Eliminar de mi biblioteca Imprimir

    Exportación citas

  • Fichero

  • Contenido

Vol 158 - N° 2

P. 103-110 - avril 2021 Regresar al número
Artículo precedente Artículo precedente
  • And now… thyroidectomy through a transoral approach!
  • C. Nomine-Criqui, L. Brunaud
| Artículo siguiente Artículo siguiente
  • What results can be expected one year after complex incisional hernia repair with biosynthetic mesh?
  • E. Vauclair, M. Bert, O. Facy, N. Cheynel, P. Rat, P. Ortega-Deballon

Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
El acceso al texto completo de este artículo requiere una suscripción.

Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
La compra de artículos no está disponible en este momento.

¿Ya suscrito a @@106933@@ revista ?

Mi cuenta

Declaración CNIL

EM-CONSULTE.COM se declara a la CNIL, la declaración N º 1286925.

En virtud de la Ley N º 78-17 del 6 de enero de 1978, relativa a las computadoras, archivos y libertades, usted tiene el derecho de oposición (art.26 de la ley), el acceso (art.34 a 38 Ley), y correcta (artículo 36 de la ley) los datos que le conciernen. Por lo tanto, usted puede pedir que se corrija, complementado, clarificado, actualizado o suprimido información sobre usted que son inexactos, incompletos, engañosos, obsoletos o cuya recogida o de conservación o uso está prohibido.
La información personal sobre los visitantes de nuestro sitio, incluyendo su identidad, son confidenciales.
El jefe del sitio en el honor se compromete a respetar la confidencialidad de los requisitos legales aplicables en Francia y no de revelar dicha información a terceros.