Bülent Dinç1, Mehmet İlker Turan2, Umut Rıza Gündüz1, Nurhan Haluk Belen1

1Clinic of General Surgery, Health Sciences University Antalya Training and Research Hospital, Antalya, Turkey
2Clinic of General Surgery, Kepez State Hospital, Antalya, Turkey


Objective: The Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) was described in 2016 and had its case series published. This study aimed to present the largest TOETVA case series performed in Turkey.

Material and Methods: Data from 52 patients who underwent TOETVA procedure between February 2018 and October 2019 were analyzed retrospectively. Demographic data, duration of operation, blood loss, rate of conversion to open surgery, radiological findings, pathological outcomes, and complications were analyzed.

Results: All patients were female. Mean duration of the operation was 192 ± 45 minutes, mean blood loss was 39 ± 47 mL, and the ratio of surgical site infection was 6% (3/50). In two (4%) patients, TOETVA was converted to open surgery. Temporary and permanent recurrent laryngeal nerve (RLN) paralysis was observed in 2 (4%) and 0 patients, respectively. Temporary and permanent hypoparathyroidism was observed in 10 (20%) and 0 patients, respectively.

Conclusion: TOETVA procedure is the most recently defined NOTES technique for endocrine surgery. In experienced healthcare centers, TOETVA can achieve outcomes similar and even better than the ones obtained with open surgery. The complication rates, durations of operation, surgical site infection, and blood loss parameters that we observed in our experience are similar to the ones reported in the literature.

Keywords: Minimally invasive surgery, natural orifice endoscopic surgery, thyroidectomy

Cite this article as: Dinç B, Turan Mİ, Gündüz UR, Belen NH. Transoral endoscopic thyroidectomy vestibular approach (TOETVA): Our outcomes from Turkey. Turk J Surg 2020; 36 (4): 340-346.


Ethics Committee Approval

The approval for this study was obtained from Antalya Local Ethics Committee for Clinical Research (Decision No: 12/22, Date: 02.05.2019).

Peer Review

Externally peer-reviewed.

Author Contributions

Concept - B.D.; Design - B.D., M.İ.T.; Supervision - B.D., M.İ.T., U.R.G., N.H.B.; Data Collection and/or Processing - B.D., M.İ.T., U.R.G., N.H.B.; Analysis and/or Interpretation - B.D., U.R.G.; Literature Review - B.D.; Writing Manuscript - B.D.; Critical Reviews - B.D., M.İ.T., U.R.G., N.H.B.

Conflict of Interest

All authors declare that they have no competing interests.

Financial Disclosure

No financial support was used for this study.