A doctor gently touches a woman's neck so she can feel the thyroid glands

The Scarless Approach to Thyroid Surgery

As research continues to lead to groundbreaking medical advancements, surgeries become less invasive and recovery times decrease. Such is true for thyroidectomies and parathyroidectomies, surgeries to remove part or all of the thyroid or parathyroid glands, respectively. The transoral vestibular approach (TOVA) offers eligible patients the opportunity to skip invasive procedures and opt for a minimally invasive laparoscopic approach instead. Currently, Baylor St. Luke’s Medical Center is the only center in Texas that offers this novel procedure.

How Does the Transoral Vestibular Approach Work? 

After putting the patient under anesthesia, a surgeon will make three incisions in the area in front of the bottom teeth, each about 3-10 millimeters long. The surgeon will then thread a small fiber-optic camera and thin surgical tools through the incisions. The doctor will place the item they’re removing (whether it be a nodule or a part—or all—of the thyroid or parathyroid) in a bag and pull it out through the middle incision. The surgeon will then use dissolvable stitches to close up the three incisions. 

Who Is Eligible for a Scarless Thyroid Surgery?

The small size of the incisions can limit candidacy for the TOVA procedure. However, Raymon Grogan, MD, MS, Section Chief of Endocrine Surgery at Baylor St. Luke’s Medical Center, and his team recently performed an analysis on 1,000 patients who underwent thyroid surgery and concluded that 56% of them were eligible for and could have received the scarless procedure. Dr. Grogan is one of only a few experts on the TOVA procedure in the United States, and he was the first surgeon to perform this operation in the Midwest and in all of Texas.

You might be a candidate if: 

  • You have a benign thyroid condition, such as goiter or Graves’ disease, that requires a thyroidectomy. 
  • You have a cancerous thyroid nodule that’s smaller than 2 cm.
  • You have a benign thyroid nodule that’s smaller than 6 cm.
  • You have primary hyperparathyroidism or an eligible case of secondary or tertiary hyperparathyroidism. 

What Are the Benefits of the TOVA Procedure? 

Unlike the traditional thyroidectomy procedure, which requires an incision in the neck, the TOVA  leaves no visible scars. Since there are no large incisions involved, patients typically only have to stay in the hospital for one night after the procedure and can often return to their normal lives soon after. 

If you’d like to learn more about the TOVA, schedule an appointment with your St. Luke’s Health endocrinologist. After reviewing your condition and determining candidacy, they can refer you to a qualified general surgeon for treatment. 

Baylor College of Medicine | Scarless Thyroid and Parathyroid Surgery
MedPage Today | Is Transoral Endocrine Surgery Underused in Thyroid Operations?

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