Have you ever considered thyroid surgery but worried about visible scarring on your neck? Today, a revolutionary technique called TOETVA (Transoral Endoscopic Thyroidectomy Vestibular Approach) makes it possible to remove the thyroid gland without any external scars – by accessing it through the mouth using a small camera and specialized instruments.
What Is TOETVA?
TOETVA is an endoscopic thyroid surgery technique performed entirely through the mouth, leaving no visible external scars. It is ideal for patients who need thyroid surgery but are concerned about neck scarring. Small incisions are made inside the lower lip, and the surgeon uses a camera and specialized tools to remove the thyroid – no neck incision required. This helps patients feel more confident after surgery.
Who Is a Good Candidate?
- Thyroid nodules up to 4 cm in size
- Benign nodules or thyroid cysts up to 4 cm
- Early-stage papillary thyroid carcinoma without lymph node involvement
Pre-Operative Preparation
- Undergo a thorough physical examination to assess suitability
- Ultrasound and Fine Needle Aspiration (FNA) to determine nodule type
- Thyroid Function Test (blood test)
- Fast for at least 6–8 hours before surgery
- Stop blood-thinning medications such as Aspirin, Warfarin, or Clopidogrel at least 5–7 days before surgery (consult your doctor before stopping)
- Continue thyroid medications such as Levothyroxine as usual, unless instructed otherwise
- Avoid smoking and alcohol at least 1–2 weeks before surgery
Post-Operative Care
- Rinse mouth with saline or antiseptic solution 3–4 times daily
- Apply cold compress to the chin and neck for the first 48 hours to reduce swelling
- Eat soft, easy-to-chew foods such as porridge, soup, or congee
- Stay hydrated and avoid hot, spicy, or hard foods
- Take all medications as prescribed
Warning Signs — Seek Medical Attention Immediately
- Unusual bleeding from the mouth
- Difficulty swallowing or breathing
- Significant swelling, redness, or discharge from the wound
- High fever or pain that does not improve with medication
Advantages
- No visible external scarring
- Faster recovery
- Reduced risk of neck wound complications
Limitations
- Not suitable for nodules larger than 4 cm or spreading cancer
- Temporary swelling or numbness around the mouth and chin may occur post-surgery
TOETVA is an excellent option for patients seeking thyroid surgery without visible scarring. However, the choice of surgical method should always be made in consultation with a specialist, based on each patient’s individual condition and medical needs.
