Nerve Monitoring After Transoral Endoscopic Thyroid Resection

Background: The number of patients demanding endoscopic neck surgery is rising. The access trauma of the axillary, breast and chest approaches is bigger than in open or video assisted surgery. We tested the feasibility of he sublingual transoral access which is in our opinion the only real minimally...-invasive extracollar endoscopic access to the thyroid gland Methods: We performed an experimental investigation in a porcine model. In 10 pigs we made 10 endoscopic transoral thyroidectomys with a modified axilloscope with the help of ultrasonic scissors and a neuro-monitoring system for identification of the recurrent laryngeal nerve. Results: The average operation time from the introduction to the removal of the obturator just above the larynx was 57 seconds. The mean operation time was 43 minutes. With the help of the neuro-monitoring system we proved in all cases the function of the recurrent laryngeal nerve on both sides. The pigs were observed for another two hours after operation. During and after the operation no complications appeared. Conclusions: We could show that the endoscopic transoral thyroid resection in pigs is possible and save. Our results might be useful for using this access for endoscopic thyroid resection in humans.