{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T17:29:29Z","timestamp":1786728569619,"version":"build-2736575974"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:p>\n                    Conventional open thyroidectomy is often associated with post-operative complications including nerve damage, voice disturbances, paraesthesias, adhesions and prominent scarring. Several endoscopic surgical techniques have been reported as alternatives to conventional thyroidectomy. Natural orifice transluminal endoscopic surgery is a promising approach which leaves no scar, produces few complications and affords faster discharge from care. Several studies have explored its utility in total thyroidectomy in patients with benign or malignant thyroid disease. Herein, we present a case series on the successful application of transoral endoscopic total thyroidectomy vestibular approach (TOETVA) in benign and malignant diseases of the thyroid. We performed TOETVA in 11 patients presenting with benign or malignant thyroid nodules in our hospital, between 1\n                    <jats:sup>st<\/jats:sup>\n                    January 2015 and 30\n                    <jats:sup>th<\/jats:sup>\n                    June 2016. The surgery was completed successfully in all patients with a pre-operative diagnosis of multinodular goitre. The surgery was performed under general anaesthesia and the mean operative time was 130 min. The mean blood loss was 2\u20133 cc. No incidence of recurrent laryngeal nerve injury, damage to mental nerve, parathyroid damage or peri-incisional adhesion occurred in the study participants. No visible scarring occurred in the patients following surgery. The patients had an uneventful recovery after the surgery and were discharged after 4 days. TOETVA is safe and effective in the surgical management of multinodular goitre and offers a scar-free alternative to conventional surgery.\n                  <\/jats:p>","DOI":"10.4103\/jmas.jmas_3_17","type":"journal-article","created":{"date-parts":[[2017,10,23]],"date-time":"2017-10-23T05:25:40Z","timestamp":1508736340000},"page":"118-123","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":13,"title":["Transoral endoscopic total thyroidectomy vestibular approach: A case series and literature review"],"prefix":"10.4103","volume":"14","author":[{"given":"T.","family":"Sivakumar","sequence":"first","affiliation":[{"name":"Associate Professor in Fellowship of Minimal Access Surgey, Siva Hospital, Institute of Minimal Access Surgery, Kanyakumari, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. A.","family":"Amizhthu","sequence":"additional","affiliation":[{"name":"Associate Professor in Fellowship of Minimal Access Surgey, Siva Hospital, Institute of Minimal Access Surgery, Kanyakumari, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250519","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1016\/j.surg.2006.08.008","article-title":"Voice and swallowing changes after thyroidectomy in patients without inferior laryngeal nerve injuries","volume":"140","author":"Lombardi","year":"2006","journal-title":"Surgery"},{"key":"R2-20250519","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1177\/0194599813482299","article-title":"Esophageal motility changes after thyroidectomy; possible associations with postoperative voice and swallowing disorders: Preliminary results","volume":"148","author":"Scerrino","year":"2013","journal-title":"Otolaryngol Head Neck Surg"},{"key":"R3-20250519","first-page":"7359","article-title":"Reduced incidence of postoperative symptoms following a novel bilateral supraclavicular approach to open thyroidectomy: A randomized clinical trial in a Chinese population","volume":"8","author":"Lv","year":"2015","journal-title":"Int J Clin Exp Med"},{"key":"R4-20250519","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1089\/105072502760258677","article-title":"Endoscopic thyroid surgery today: A diversity of surgical strategies","volume":"12","author":"Yeung","year":"2002","journal-title":"Thyroid"},{"key":"R5-20250519","first-page":"189296","article-title":"Natural orifice translumenal endoscopic surgery in humans: A review","volume":"2012","author":"Clark","year":"2012","journal-title":"Minim Invasive Surg"},{"key":"R6-20250519","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1007\/s00268-015-3320-1","article-title":"Transoral endoscopic thyroidectomy vestibular approach: A series of the first 60 human cases","volume":"40","author":"Anuwong","year":"2016","journal-title":"World J Surg"},{"key":"R7-20250519","doi-asserted-by":"crossref","first-page":"1871","DOI":"10.1007\/s00464-007-9734-6","article-title":"Transoral access for endoscopic thyroid resection","volume":"22","author":"Witzel","year":"2008","journal-title":"Surg Endosc"},{"key":"R8-20250519","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1007\/s00464-009-0347-0","article-title":"Natural orifice surgery on thyroid gland: Totally transoral video-assisted thyroidectomy (TOVAT): Report of first experimental results of a new surgical method","volume":"23","author":"Benhidjeb","year":"2009","journal-title":"Surg Endosc"},{"key":"R9-20250519","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1007\/s00268-010-0846-0","article-title":"Endoscopic minimally invasive thyroidectomy (eMIT): A prospective proof-of-concept study in humans","volume":"35","author":"Wilhelm","year":"2011","journal-title":"World J Surg"},{"key":"R10-20250519","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1007\/s00464-012-2588-6","article-title":"Trans-Oral Video-Assisted Neck Surgery (TOVANS). 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