Abstract
Introduction:
Transoral endoscopic thyroidectomy through vestibular approach (TOETVA) is a new technique that has become more popular worldwide because of its many advantages. 1 –4 However, this novel approach for thyroid cancer treatment in children is highly challenging, even for high-volume surgeons. 5,6 In our study, we report a video of TOETVA for a pediatric patient with thyroid cancer.
Patient and Methods:
A 14-year-old female was found to have cT1aN0M0 papillary thyroid carcinoma (PTC) with 7 and 5 mm tumor size. The patient's weight was 35 kg. The patient underwent right hemithyroidectomy with isthmusectomy and ipsilateral central neck dissection through the transoral endoscopic approach.
Results:
The operative time was 85 minutes. The pathologic results were PTC. The number of harvested lymph nodes was five with one positive lymph node. The stage was pT1aN1aM0. The patient was discharged 3 days after surgery without any complications such as bleeding, infection, mental nerve damage, permanent hoarseness, or hypoparathyroidism. The patient was completely satisfied with the cosmetic result. However, this technique was more challenging in children than in adults because the body size was smaller in children than in adults. It could lead to difficulty in insertion of trocars. Moreover, the chance of instrument collision may be higher.
Conclusion:
TOETVA may be a new, feasible, and safe approach for selected pediatric patients with PTC. To the best of our knowledge, this is the first TOETVA video in children. We highly recommend that only high-volume thyroid surgeons with experience of TOETVA should perform TOETVA on the pediatric population.
No competing financial interests exist.
Patient Consent:
The authors have received and archived patient consent for video recording/publication in advance of video recording of procedure.
Runtime of video: 09 mins 01 secs
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