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1

Kim, Hong Kyu, Hoon Yub Kim, Young Jun Chai, Gianlorenzo Dionigi, Eren Berber, and Ralph P. Tufano. "Transoral Robotic Thyroidectomy." Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 28, no. 6 (2018): 404–9. http://dx.doi.org/10.1097/sle.0000000000000587.

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2

Park, Dawon, Hong Kyu Kim, and Hoon Yub Kim. "Transoral Robotic Thyroidectomy." International Journal of Thyroidology 11, no. 1 (2018): 26. http://dx.doi.org/10.11106/ijt.2018.11.1.26.

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3

Ng, Wai-Tat. "Transoral endoscopic thyroidectomy." Surgical Practice 17, no. 2 (2013): 77–78. http://dx.doi.org/10.1111/1744-1633.12011.

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4

Giorgio Calò, Pietro, Fabio Medas, Gian Luigi Canu, and Enrico Erdas. "Monitored transoral endoscopic thyroidectomy." Gland Surgery 8, no. 4 (2019): 318–21. http://dx.doi.org/10.21037/gs.2018.07.07.

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5

Zhang, Daqi, Hoon Yub Kim, Ralph P. Tufano, and Gianlorenzo Dionigi. "Single port transoral thyroidectomy." Gland Surgery 9, no. 2 (2020): 159–63. http://dx.doi.org/10.21037/gs.2020.01.09.

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6

Shaha, Ashok R. "Transoral thyroidectomy-learning curve." Archives of Endocrinology and Metabolism 65, no. 3 (2021): 255–56. http://dx.doi.org/10.20945/2359-3997000000382.

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7

Jamikorn, Tanyanan, and Angkoon Anuwong. "Transoral Endoscopic Thyroidectomy (TOETVA)." Current Otorhinolaryngology Reports 7, no. 3 (2019): 209–18. http://dx.doi.org/10.1007/s40136-019-00250-0.

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8

Seo, Woogeun, Yong Bae Ji, Kyung Tae, and Chang Myeon Song. "Transoral Robotic Lingual Thyroidectomy." International Journal of Thyroidology 15, no. 2 (2022): 116–20. http://dx.doi.org/10.11106/ijt.2022.15.2.116.

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9

Zalazar, Alejandro M., Javier L. Rossi, José M. Moreno Negri, and Francisco Santucho Saravia. "Tiroidectomía transoral endoscópica por abordaje vestibular." Revista Argentina de Cirugía 112, no. 2 (2020): 185–88. http://dx.doi.org/10.25132/raac.v112.n2.1439.es.

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Natural orifice transluminal endoscopic surgery (NOTES) was applied for the first time by K. Witzel in 2008, introducing the transoral endoscopic resection of the thyroid gland in human cadavers and living pigs. In 2016, A. Anuwong published the first case series using the vestibular approach in humans. We report the case of a 37-year-old female patient with a mass in the anterior aspect of the neck which appeared two months before consultation. The thyroid ultrasound reported multinodular goiter. The fine-needle aspiration (FNA) biopsy reported hyperplastic follicular nodule in both lobes. Th
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10

Fernandez-Ranvier, Gustavo, Aryan Meknat, Daniela E. Guevara, and William B. Inabnet. "Transoral Endoscopic Thyroidectomy Vestibular Approach." JSLS : Journal of the Society of Laparoendoscopic Surgeons 23, no. 4 (2019): e2019.00036. http://dx.doi.org/10.4293/jsls.2019.00036.

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11

Witzel, Kai, Achim Hellinger, Cornelia Kaminski, and Tahar Benhidjeb. "Endoscopic thyroidectomy: the transoral approach." Gland Surgery 5, no. 3 (2016): 336–41. http://dx.doi.org/10.21037/gs.2015.08.04.

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12

Kim, Wan Wook. "Transoral Thyroidectomy: Advantages and Disadvantages." Journal of Minimally Invasive Surgery 23, no. 3 (2020): 112–13. http://dx.doi.org/10.7602/jmis.2020.23.3.112.

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13

Le, Quang V., Duy Q. Ngo, Toan D. Tran, and Quy X. Ngo. "Transoral Endoscopic Thyroidectomy Vestibular Approach." Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 30, no. 3 (2020): 209–13. http://dx.doi.org/10.1097/sle.0000000000000764.

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14

Erinjeri, Neeta J., and Robert Udelsman. "Transoral Endoscopic Thyroidectomy Vestibular Approach." Advances in Surgery 53 (September 2019): 179–93. http://dx.doi.org/10.1016/j.yasu.2019.04.009.

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15

Abeywardana, Charaka Yapa, and Ramya Amarasena. "Anaesthesia for Transoral Endoscopic Thyroidectomy." Sri Lankan Journal of Anaesthesiology 26, no. 2 (2018): 159. http://dx.doi.org/10.4038/slja.v26i2.8342.

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16

Dionigi, G., R. P. Tufano, J. Russell, H. Y. Kim, E. Piantanida, and A. Anuwong. "Transoral thyroidectomy: advantages and limitations." Journal of Endocrinological Investigation 40, no. 11 (2017): 1259–63. http://dx.doi.org/10.1007/s40618-017-0676-0.

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17

Hong, Yong Tae. "Benefits and Limitations in Transoral Endoscopic Thyroidectomy." Korean Journal of Otorhinolaryngology-Head and Neck Surgery 66, no. 1 (2023): 1–6. http://dx.doi.org/10.3342/kjorl-hns.2022.01018.

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Transoral endoscopic thyroidectomy (TOET) is the recent remote access approach which leaves no cutaneous scar in the body. It has advantages in minimize the surgical dissection, could perform total thyroidectomy and central lymph node dissection easily under a good surgical view. TOET has gained popularity in both the East and Western countries since the first large series report by Dr. Anuwong in 2016. In this article we described and critically analyze the indications and contraindications, advantages and limitations, landmarks for recurrent laryngeal nerve and strategies for superior pole d
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18

Shah, Kshitij, Shivali Patekar, Tejal Patel, and Renuka Bradoo. "Feasibility of Transoral Thyroidectomy by Vestibular Approach." Bengal Journal of Otolaryngology and Head Neck Surgery 28, no. 1 (2020): 67–70. http://dx.doi.org/10.47210/bjohns.2020.v28i1.176.

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Introduction
 An open approach to thyroidectomies through neck provides good exposure and safe dissection however, the patient still has a scar. Endoscopic thyroid surgery has been practised since the late 90s. The latest addition is the transoral endoscopic thyroidectomy by vestibular approach.
 Materials and Methods
 We at our centre performed this surgery on 3 patients. Here we present our initial experience of transoral endoscopic thyroidectomy by vestibular approach (TOETVA).
 Results
 Two of the three patients did not have any complication. Diffuse bleeding was e
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19

Liang, Tsung-Jung, Kuo-Chiang Wang, Nai-Yu Wang, I.-Shu Chen, and Shiuh-Inn Liu. "Indocyanine Green Angiography for Parathyroid Gland Evaluation during Transoral Endoscopic Thyroidectomy." Journal of Personalized Medicine 11, no. 9 (2021): 843. http://dx.doi.org/10.3390/jpm11090843.

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Indocyanine green (ICG) angiography, a real-time intraoperative imaging technique, is associated with better parathyroid identification and functional evaluation during open thyroidectomy. However, the benefits of ICG fluorescence imaging application in transoral endoscopic thyroidectomy are not well-documented. Consecutive patients who underwent transoral endoscopic thyroidectomy were retrospectively reviewed. Parathyroid glands were assessed with visual inspection followed by ICG angiography. The fluorescence intensity of all parathyroid glands was recorded. In total, 158 parathyroid glands
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20

Anuwong, Angkoon. "Transoral endoscopic thyroidectomy—essentiality of classification." Translational Cancer Research 6, S2 (2017): S450—S452. http://dx.doi.org/10.21037/tcr.2017.03.55.

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21

Dionigi, Gianlorenzo, Matteo Lavazza, Chei-Wei Wu, et al. "Transoral thyroidectomy: why is it needed?" Gland Surgery 6, no. 3 (2017): 272–76. http://dx.doi.org/10.21037/gs.2017.03.21.

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22

Razavi, Christopher R., and Jonathon O. Russell. "Indications and contraindications to transoral thyroidectomy." Annals of Thyroid 2 (2017): 12. http://dx.doi.org/10.21037/aot.2017.10.01.

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23

Wu, Che-Wei, Antonio Giacomo Rizzo, Vincenzo Bartolo, et al. "Energy based devices for transoral thyroidectomy." Annals of Thyroid 3 (February 10, 2018): 4. http://dx.doi.org/10.21037/aot.2018.01.02.

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24

Huang, Tzu-Yen, Antonina Catalfamo, Che-Wei Wu, Feng-Yu Chiang, and Gianlorenzo Dionigi. "Neural monitoring in transoral endoscopic thyroidectomy." Annals of Thyroid 3 (March 2018): 7. http://dx.doi.org/10.21037/aot.2018.03.01.

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25

Jongekkasit, Isariya, Pornpeera Jitpratoom, Thanyawat Sasanakietkul, and Angkoon Anuwong. "Transoral Endoscopic Thyroidectomy for Thyroid Cancer." Endocrinology and Metabolism Clinics of North America 48, no. 1 (2019): 165–80. http://dx.doi.org/10.1016/j.ecl.2018.11.009.

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26

Pai, Vishwanath M., Pari Muthukumar, Apoorva Prathap, Jayanth Leo, and Rekha A. "Transoral endoscopic thyroidectomy: A case report." International Journal of Surgery Case Reports 12 (2015): 99–101. http://dx.doi.org/10.1016/j.ijscr.2015.04.010.

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27

Lee, Hye Yoon, Ji Young You, Sang Uk Woo, et al. "Transoral periosteal thyroidectomy: cadaver to human." Surgical Endoscopy 29, no. 4 (2014): 898–904. http://dx.doi.org/10.1007/s00464-014-3749-6.

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28

Zhang, D., E. Caruso, H. Sun, et al. "Classifying pain in transoral endoscopic thyroidectomy." Journal of Endocrinological Investigation 42, no. 11 (2019): 1345–51. http://dx.doi.org/10.1007/s40618-019-01071-0.

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29

Wang, Dun, Yichao Wang, Shengliang Zhou, et al. "Transoral thyroidectomy vestibular approach versus non-transoral endoscopic thyroidectomy: a comprehensive systematic review and meta-analysis." Surgical Endoscopy 36, no. 3 (2021): 1739–49. http://dx.doi.org/10.1007/s00464-021-08836-w.

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30

Zhou, Silvia, and Wymen Chen. "Dr. Insoo Suh: my thoughts on transoral endoscopic thyroidectomy vestibular approach and transoral and submental thyroidectomy." Annals of Laparoscopic and Endoscopic Surgery 4 (August 2019): 13. http://dx.doi.org/10.21037/aot.2019.07.02.

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31

Cuello, Natalia L., Sergio C. Gentile, and Gustavo Fernández Ranvier. "Primera tiroidectomía transoral vestibular endoscópica (TOETVA) en la Argentina." Revista Argentina de Cirugía 111, no. 4 (2019): 284–88. http://dx.doi.org/10.25132/raac.v111.n4.1412es.

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A 53-year-old female patient with a 40-mm nodule in the left thyroid lobe underwent surgery using the transoral endoscopic thyroidectomy vestibular approach (TOETVA) because she was particularly interested in the cosmetic results. She evolved with excellent postoperative outcome. We review the literature dealing with this approach and report the first case in our country
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32

Kim, Mi Ra, Yeong Jun Park, Byung Whoo Park, et al. "Can Voice Pitch Be Preserved in Patients after Transoral Endoscopic Thyroidectomy Vestibular Approach?" Journal of Clinical Medicine 9, no. 9 (2020): 2777. http://dx.doi.org/10.3390/jcm9092777.

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Introduction: Transoral endoscopic thyroidectomy vestibular approach (TOETVA) has become increasingly popular. Several reports have emphasized the safety and efficacy of this new approach. However, there is no report on functional voice outcomes, including voice pitch change after TOETVA. Methods: The functional voice outcomes of patients undergoing TOETVA were compared with those of patients undergoing conventional thyroidectomy. A total of 82 consecutive patients were included in the study: 44 underwent thyroid lobectomy via TOETVA (transoral group) and 38 underwent thyroid lobectomy via the
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33

Kadem, Sadq G., Sarmad M. Habash, and Ali H. Jasim. "Transoral Endoscopic Thyroidectomy via Vestibular Approach: A series of the first ten cases in Iraq." Sultan Qaboos University Medical Journal [SQUMJ] 19, no. 1 (2019): 68. http://dx.doi.org/10.18295/squmj.2019.19.01.013.

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Transoral endoscopic thyroidectomy was first described as an experimental sublingual approach. This approach was modified to a vestibular approach to avoid complications. In this report, we describe the results of the first ten cases of a transoral endoscopic thyroidectomy via vestibular approach (TOETVA) performed in Iraq. All operations were performed at Al Shifa General Hospital, Basrah, Iraq, in 2017 using three laparoscopic ports inserted at the oral vestibule. One out of ten patients underwent a near total thyroidectomy, the remaining cases underwent thyroid lobectomies. The average oper
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34

Lee, Dong Won, Jeong Kyu Kim, Seung Heon Shin, and Kyung Tae. "Application of Ultrasonography for Safe Flap Elevation at the Learning Period of Transoral Thyroidectomy: A Technical Report." Korean Journal of Otorhinolaryngology-Head and Neck Surgery 65, no. 3 (2022): 180–85. http://dx.doi.org/10.3342/kjorl-hns.2021.01053.

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Transoral thyroidectomy using the vestibular approach has achieved excellent cosmetic outcomes without leaving any visible scars. However, concerns have been raised on how to prevent complications, such as skin perforation and anterior jugular vein injury, especially in the learning period. This is because working space is generally created via blind and blunt dissection using a blunt dilator through small vestibular incisions unfamiliar to beginners. Herein, we explain an intraoperative real-time ultrasound technique employed in transoral thyroidectomy to safely elevate a skin flap while avoi
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35

Wang, Yichao, Shengliang Zhou, Xueting Liu, et al. "Transoral endoscopic thyroidectomy vestibular approach vs conventional open thyroidectomy: Meta‐analysis." Head & Neck 43, no. 1 (2020): 345–53. http://dx.doi.org/10.1002/hed.26486.

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36

Kaczka, Krzysztof, and Lech Pomorski. "New Techniques in Thyroid Surgery – Critical Evaluation." Polish Journal of Surgery 91, Suplement 1 (2019): 12–16. http://dx.doi.org/10.5604/01.3001.0013.2092.

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Introduction: Operations due to benign and malignant thyroid neoplasms constitute a significant percentage of operations in general and oncological surgery wards. Therefore, unsurprisingly, better and better methods are being sought to avoid the occurrence of two major complications after those operations, i.e. laryngeal nerve palsy and hypoparathyroidism and new minimally invasive accesses. M aterial and methods: Authors searched MEDLINE database using the following search terms: modern technologies AND/ OR thyroid surgery AND/OR intermittent neuromonitoring AND/OR continuous neuromonitoring
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37

Nomine-Criqui, C., and L. Brunaud. "And now… thyroidectomy through a transoral approach!" Journal of Visceral Surgery 158, no. 2 (2021): 101–2. http://dx.doi.org/10.1016/j.jviscsurg.2021.02.005.

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38

Benhidjeb, Tahar, Michael Stark, Isabel Gerntke, Ospan Mynbaev, and Kai Witzel. "Transoral thyroidectomy—from experiment to clinical implementation." Translational Cancer Research 6, S1 (2017): S174—S178. http://dx.doi.org/10.21037/tcr.2017.01.23.

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39

Stark, Michael, and Tahar Benhidjeb. "The NESA transoral thyroidectomy at a crossroad." Gland Surgery 9, no. 5 (2020): 1170–71. http://dx.doi.org/10.21037/gs-20-549.

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40

Richmon, Jeremy D., and Hoon Yub Kim. "Transoral robotic thyroidectomy (TORT): procedures and outcomes." Gland Surgery 6, no. 3 (2017): 285–89. http://dx.doi.org/10.21037/gs.2017.05.05.

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41

Benhidjeb, Tahar. "Transoral Endoscopic Thyroidectomy with Central Neck Dissection." Chinese Medical Journal 128, no. 13 (2015): 1838. http://dx.doi.org/10.4103/0366-6999.159366.

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42

Gryaznov, S. E., G. G. Melkonyan, A. M. Shulutko, V. I. Semikov, E. G. Osmanov, and E. G. Gandybina. "TRANSORAL THYROIDECTOMY AND PARATHYROIDECTOMY: SERIES OF CASES." Novosti Khirurgii 29, no. 3 (2021): 382–91. http://dx.doi.org/10.18484/2305-0047.2021.3.382.

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Objective. To present the results of the author’s own series of transoral operations in patients with pathology of the thyroid and parathyroid glands. Methods. Transoral surgery was performed in women (n=20) and (n=1) man. All patients were operated on for the primary disease and met the selection criteria based on ultrasound and cytological examinations, hormonal levels, and somatic status. Indications for surgery were: nodular goiter in 17 cases, diffuse toxic goiter - in 2 cases, parathyroid adenoma - in 2 cases. The surgical technique included a three-port approach in the lower fornix of t
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43

Park, Jun-Ook, Mi-Ra Kim, Do Hun Kim, and Dong Kun Lee. "Transoral endoscopic thyroidectomy via the trivestibular route." Annals of Surgical Treatment and Research 91, no. 5 (2016): 269. http://dx.doi.org/10.4174/astr.2016.91.5.269.

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44

Kim, Hong Kyu, Dawon Park, and Hoon Yub Kim. "Robotic transoral thyroidectomy for papillary thyroid carcinoma." Annals of Surgical Treatment and Research 96, no. 5 (2019): 266. http://dx.doi.org/10.4174/astr.2019.96.5.266.

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45

Dionigi, Gianlorenzo, Alessandro Bacuzzi, Matteo Lavazza, et al. "Transoral endoscopic thyroidectomy: preliminary experience in Italy." Updates in Surgery 69, no. 2 (2017): 225–34. http://dx.doi.org/10.1007/s13304-017-0436-x.

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46

Kwek, James Wei Ming, Maria Judith Pang, and Harold H. W. Heah. "Pneumoperitoneum after transoral endoscopic thyroidectomy vestibular approach." Laryngoscope Investigative Otolaryngology 5, no. 3 (2020): 580–83. http://dx.doi.org/10.1002/lio2.393.

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47

Zhang, Daqi, Dawon Park, Hui Sun, et al. "Indications, benefits and risks of transoral thyroidectomy." Best Practice & Research Clinical Endocrinology & Metabolism 33, no. 4 (2019): 101280. http://dx.doi.org/10.1016/j.beem.2019.05.004.

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48

Chen, Lena W., Christopher R. Razavi, Hanna Hong, et al. "Cosmetic outcomes following transoral versus transcervical thyroidectomy." Head & Neck 42, no. 11 (2020): 3336–44. http://dx.doi.org/10.1002/hed.26383.

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49

Chang, Brent A., Ameya A. Asarkar, and Cherie‐Ann O. Nathan. "What is the Role of Transoral Thyroidectomy?" Laryngoscope 130, no. 9 (2020): 2096–97. http://dx.doi.org/10.1002/lary.28578.

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50

Alnehlaoui, Fadi, and Salman Yousuf Guraya. "Transoral and submental thyroidectomy using intraoperative nerve stimulation and indocyanin green fluorescence imaging." BMJ Case Reports 14, no. 8 (2021): e243306. http://dx.doi.org/10.1136/bcr-2021-243306.

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There is a recent proliferation of clinical studies about the minimally invasive scarless thyroid surgery. The transoral endoscopic thyroidectomy vestibular approach (TOETVA) carries a great potential for being scarless surgery via a short dissection flap. However, TOETVA has limitations in extracting larger thyroid tumours via the transoral vestibular incision and due to its potential damage to the branches of the mental nerve. The rapidly evolving surgical innovations have now introduced transoral and submental thyroidectomy (TOaST) approach that allows extraction of large thyroid tumours wi
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