Endoscopic thyroid surgery without scarring

Traditionally, the surgical removal of the thyroid, as well as a parathyroid adenoma, is done through an incision in a visible spot on the skin of the neck.

Even techniques such as MIVAT that have been rather abusively dubbed as “minimally invasive” remain in the category of “open surgery” and they too have a sharp mark on the front of the neck. TOETVA, an innovative method, came to provide a solution to the aesthetic part of the mark on the skin of the neck.

TOETVA method
“A purely endoscopic technique, i.e. a “closed” surgery, the TOETVA method, in which no skin incision needs to be made in order to completely remove the thyroid. This innovative technique, based on advanced laparoscopic technology, is performed with thin laparoscopic instruments through 3 small holes in the oral cavity, and the thyroid is removed using an endobag. The incisions do not hurt and are not visible at all, and they heal completely so that after 1 week they are not even visible. The technique is also indicated for the removal of a parathyroid gland adenoma”, points out Mr. Aristotelis Kehagias, MD, PhD, FACS, Endocrine Gland Surgeon, Metropolitan General.

Thanks to TOETVA there is no mark anywhere on the skin, so full esthetics is achieved in the neck area. In contrast, other thyroid removal techniques – even the ones claimed to be “minimally invasive” – ​​always leave a scar, which can become particularly disfiguring in the event of a healing problem with the creation of a hypertrophic scar or keloid.

In many people who have a mark in such a prominent place, a psychological residue can be created, and a possible change in daily habits, clothing, or movements to hide it from the eyes of others.

Operation safety
TOETVA is a safe operation and is becoming increasingly popular in leading hospitals abroad. Its safety profile has been proven by reputable scientific studies, which have concluded that the technique is as safe as the classic open method and that it completely removes (“cleanses”) the thyroid without residue. However, studies emphasize that TOETVA should be performed by a highly skilled surgeon who has combined experience in open thyroid surgery and high laparoscopic training.

In addition, its advantage over open surgery is that a 3D camera is used, which presents the surgical field in supermagnification. This facilitates the surgeon for radical removal of the thyroid, as well as the identification of important anatomic structures that should not be disturbed such as the parathyroid glands and laryngeal palindromic nerves. Also, a neurostimulator and laparoscopic ultrasound transection are used.

TOETVA is indicated for benign conditions (nodules, goitre, etc.), but also for carcinomas that require central cleaning (removal) of the lymph nodes. The method is relatively recent (2016) but its indications are expanding.

Restoration

“Recovery after minimally invasive TOETVA is immediate. The patient will speak as soon as the operation is completed, will not be in pain (no painkillers will be needed), and approximately 2-3 hours after the operation will be able to eat and move around. He will be back to his daily routine in less than 24 hours.

In conclusion, TOETVA is the only fully endoscopic thyroid gland removal operation, which has the absolute aesthetic advantage without any marks on the skin,” concludes Mr. Kehagias.

Written by:

Mr. Aristotelis Kechagias, MD, PhD, FACS, Endocrine Surgeon, Metropolitan General

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