Transoral thyroidectomy- Breaking new grounds

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Author: P. Pai
Date: April-June 2019
From: Journal of Postgraduate Medicine(Vol. 65, Issue 2)
Publisher: Medknow Publications and Media Pvt. Ltd.
Document Type: Editorial
Length: 961 words
Lexile Measure: 1380L

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Byline: P. Pai

Transoral thyroidectomy is the latest natural orifice approach to the thyroid which espouses cosmesis. The present issue of the journal has published an article which is a single-center initial experience in the Indian setting [1] using the standard three-port transvestibular technique with CO[sub]2 insufflation.

Innovation and progress are synonymous with human evolution. Evolution is important for survival and propagation. Surgery as a medical science has progressed with evolution of technology. The basic surgical tenets are enshrined and cannot change. However, new technology improves our ability to access, visualize, and resect safely while minimizing morbidity and improving outcomes. As in any technology adoption, the Rogers Curve [2] shows five stages from innovators, early adopters, early majority, late majority, and the laggards. The thyroidectomy saga has also advanced similarly. These surgeons [1] are early adopters of technology and from a tertiary referral centre; which augers well for teaching and training of future surgeons.

Minimally invasive video-assisted thyroidectomy popularized by Professor Paulo Micoli [3] from Italy brought into focus the last bastion which impeded the surgeon from doing the ultimate in surgery—a cosmetic expandable safe access. The only limitation remained the size of the thyroid gland with restrictions of 20 cc volume. The endoscopic transaxillary and bilateral axillary and breast access relocated the scar from the neck to the axilla. Robotic surgery using the axillary, breast, and retroauricular route improved control, vision, and reduced tremor and surgical stress. Thus, remote...

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Gale Document Number: GALE|A584164897