Monitored transoral endoscopic thyroidectomy via long monopolar stimulation probe

Gianlorenzo Dionigi, Che-Wei Wu, Ralph P. Tufano, Antonio Giacomo Rizzo, Angkoon Anuwong, Hui Sun, Paolo Carcoforo, Cancellieri Antonino, Mattia Portinari, Hoon Yub Kim


This video aimed to describe the role of intraoperative neuromonitoring (IONM) during transoral endoscopic thyroidectomy vestibular approach (TOETVA) with emphasis given to IONM technical and technological notes, the identification of recurrent laryngeal nerve (RLN). Standardized technique of IONM consist in identifying and monitoring both the vagus nerve and the RLNs before and after resection (V1, V2, R1, R2). According to this report, IONM during TOETVA is feasible and safe in providing identification and function of laryngeal nerves. IONM enable surgeons to feel more comfortable with their initial approach to TOETVA or extended indications. Larger series are needed for appropriated evaluation of IONM in reduction of the rates for RLN complications.