CAN THE ENDOSCOPIC TRANSORAL THYROIDECTOMY BE APPLICABLE TO ALL THYROID DISORDERS?
Endoscopic removal of the thyroid gland by mouth is the most modern and innovative technique in the field of minimally invasive surgery. As such, it has specific application indications determined by the studies of the specialized centers where it is applied, in order to ensure its safety and effectiveness. These indications are:
- Gland diameter not exceeding 10cm
- Calculated tumor volume not exceeding 50ml
- Dominant nodule size up to 5cm
- Benign diseases such as simple cyst, nodular and polyozygous goiter, toxic adenoma
- Diseases of the parathyroid glands
Centers with a very large number of cases have, individually, included in the indications and specific cases of malignancy, such as follicular thyroid cancer and papillary microcarcinoma without signs of metastasis.
However, in addition to the above, there are also cases where the application of the technique is prohibited, such as the previous irradiation of the cervical region. In addition, patients who cannot receive general anesthesia or who have had surgery on their cervix or who have recurrent goiter are excluded from candidates for oral endoscopic access. Finally, poor oral hygiene is a contraindication to the technique due to the risk of transmitting the bacteria of the oral flora to the aseptic area of the cervix.
In any case, it is important to refer to a surgeon who is familiar with the physiology and pathology of the thyroid gland, has experience not only in endocrine surgery but also in advanced endoscopic techniques, and of course has been certified in oral access.