History and Evolution of Transoral Thyroidectomy Approach
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The era of thyroid surgery in Europe started in the late nineteenth century by pioneers like Kocher, Billroth, and Halsted. At that time, patients’ survival was the main objective. After developing dissection devices, tools for hemostasis, and the intraoperative nerve monitoring system, patient safety became the main aim in thyroid surgery. Today it is a highly standardized technique and one of the safest procedures in surgery with very low morbidity. The next quest was to achieve cosmetically better results—through smaller neck incisions and remote access approaches to avoid a neck scar. As the first group who initiated the transoral access to the thyroid, we report on our personal experience and conceptual design in dealing with this innovative approach that was part of our Natural Orifice Surgery (NOS/NOTES) project, which is the next step in the evolution of minimally invasive surgery. Transoral thyroidectomy by the vestibular approach is now a safe method that represents a breakthrough for the patient and a paradigm shift in the history of thyroid surgery toward a “scarless” surgery.
KeywordsThyroid surgery Modern history Evolution Transoral approach Minimally invasive NOTES Scarless surgery
- 1.Haddad FS. Abulcasis. Abbottempo. 1968;3:22–5.Google Scholar
- 3.Halsted WS. The operative history of goiter. The author’s operation. Johns Hopkins Hosp Rep. 1920;19:71–257.Google Scholar
- 8.Benhidjeb T, Anders S, Bärlehner E. Total video-endoscopic thyroidectomy via axillo-bilateral-breast-approach (ABBA). Langenbeck's Arch Surg. 2006;391:48–9.Google Scholar
- 16.Wilhelm T, Harlaar J, Kerver A, Kleinrensink GJ, Benhidjeb T. Surgical anatomy of the floor of mouth and the cervical spaces as a rationale for trans-oral, minimal-invasive endoscopic surgical procedures - results of cadaver studies. Eur Arch Otorhinolaryngol. 2011;267:1285–90.CrossRefGoogle Scholar
- 19.Downton D. Mylohyoid ridge resection. Dent Rec. 1954;74:212.Google Scholar
- 33.Benhidjeb T, Witzel K, Burghardt J, Bärlehner E, Stark M, Mann O. Endoscopic minimally invasive thyroidectomy: ethical and patients safety considerations on the first clinical experience of an innovative approach. Surg Endosc. 2010;. Aug 24; https://doi.org/10.1007/s00464-010-1290-9.
- 40.Nakajo A, Arima H, Hirata M, Mizoguchi T, Kijima Y, Mori S, Ishigami S, Ueno S, Yoshinaka H, Natsugoe S. Trans-oral video-assisted neck surgery (TOVANS). A new transoral technique of endoscopic thyroidectomy with gasless premandible approach. Surg Endosc. 2013 Apr;27(4):1105–10.CrossRefPubMedPubMedCentralGoogle Scholar