The approach of surgical techniques has evolved significantly over the last decade, with natural orifice surgeries replacing traditional open approaches. In 2016, Angkoon Anuwong, in Thailand, demonstrated it was possible to perform thyroidectomies in a series of patients by a transoral endoscopic ap-proach - transoral endoscopy thyroidectomy vestibular approach (TOETVA) - with similar complication rates when compared to conventional surgeries. This transoral surgery has become a safe alternative with better cosmetic results, compared to conventional open-route procedures, like Kocher cervi-cotomy. Indeed, it is an option to surgically treat neoplastic and functional thyroid diseases. The technique is performed through a median incision in the oral vestibule, plus two bilateral incisions, followed by the insertion of three trocars, one centrally for a camera, and two laterally for working instruments. Although revolutionary, TOETVA has its technical limitations. Therefore, it is important to precisely define the preoperative eligibility criteria for this type of surgical approach. High-resolution ultrasound is the first imaging modality for the assessment of thyroid nodules, lymph node metastases and surgical field. The aim of this article is to outline the sonographic technique and the role of high-resolution ultrasound in the presurgical evaluation of TOETVA.
Keyphrases
- high resolution
- ultrasound guided
- minimally invasive
- lymph node
- magnetic resonance imaging
- end stage renal disease
- mass spectrometry
- high speed
- chronic kidney disease
- ejection fraction
- newly diagnosed
- endoscopic submucosal dissection
- prognostic factors
- contrast enhanced ultrasound
- tandem mass spectrometry
- peritoneal dialysis
- patients undergoing
- squamous cell carcinoma
- transcription factor
- computed tomography
- hearing loss
- coronary artery disease
- papillary thyroid
- coronary artery bypass
- early stage
- sentinel lymph node
- convolutional neural network
- optic nerve