The Feasibility of a Prototype Thyroidoscope for Gasless Transoral Endoscopic Thyroidectomy: A Preclinical Cadaver Study

Objective: This study aimed to evaluate the feasibility of the gasless transoral endoscopic thyroidectomy vestibular approach (TOETVA) using the Thyroidoscope, developed to maintain the surgical working space without CO2 insufflation. Materials and Methods: To prevent a potentially fatal CO2-related complication, we developed a retractable device, named the Thyroidoscope, which could maintain the surgical working space without CO2 insufflation. We conducted a preclinical cadaver study to evaluate its use in gasless TOETVA. Results: The Thyroidoscope provided a secure surgical field and stable image on the screen. We could successfully identify the recurrent laryngeal nerve, parathyroid gland, and other critical structures without inadvertent injury due to insertion of the Thyroidoscope. Conclusions: The Thyroidoscope provides sufficient working space to perform transoral thyroid surgery without the need for CO2 insufflation. Gasless TOETVA with the Thyroidoscope seems to be feasible and safe.