Application of Endoscopic Aspirator on Gasless Transoral Endoscopic Vestibular Thyroidectomy

Abstract

Abstract Background Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is gradually becoming mature.At the same time, the disadvantages of CO2 inflatable TOETVA are also widely recognized, and there is no uniform standard alternative.Here, we report our initial experience and discuss the safety and effectiveness of maintaining the operative space with endoscopic suction support in TOETVA. Methods We retrospectively analyzed 60 patients treated with our laparoscopic aspirator-supported TOETVA from March 2022 to June 2023.We extended the three-hole endoscopic suction device from the median incision of the oral vestibule into the operation space, pressed it down, and fixed it to support and maintain the stability of the space.Evaluate its surgical safety and prognosis. Results The study included 60 patients who were treated with endoscopic aspirator-supported TOETVA.The average operation time was 141. 14±36. 15min.The average number of dissected lymph nodes was 4. 67±3. 75.Two of them were converted to laparotomy, and no serious postoperative complications occurred in any of the patients.Postoperative complications included 1 case of transient recurrent laryngeal nerve paralysis, 1 case of transient hypoparathyroidism, and 8 cases of transient lower lip numbness.There was 1 case of postoperative skin injury and 4 cases of postoperative skin ecchymosis.Two cases of temporary loss of smell or taste recovered within 1-3 months.There is no evidence of specific complications associated with the use of suction to support the surgical space. Conclusion The operation space of TOETVA is supported by a laparoscopic suction device, which is easy to operate, convenient to obtain materials, and optimizes the clarity of the surgical field, which has the potential for wide application.