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The thyroid gland is an important endocrine gland in the body. It functions to produce and secrete hormones that regulate energy metabolism and the functioning of various systems in the body. When the thyroid gland malfunctions, surgery may be an option for treatment. Currently, surgical technology has advanced significantly, especially endoscopic thyroid surgery without scars, including the innovative transoral surgical technique. This technique has the advantage that patients will have no scars after surgery, the surgical wounds are small, recovery time is shorter, helping patients to quickly regain a good quality of life.
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Table of Contents for Endoscopic Thyroid Surgery
<ul>
<li style="font-weight: 400">Why undergo thyroid surgery (Thyroidectomy)?</li>
<li style="font-weight: 400">Types of surgical treatment for thyroid nodules
<ul>
<li style="font-weight: 400">Open thyroidectomy (incision at the neck)</li>
<li style="font-weight: 400">Endoscopic thyroidectomy</li>
</ul>
</li>
<li style="font-weight: 400">How many types of thyroid surgery are there?</li>
<li style="font-weight: 400">In-depth look at endoscopic thyroidectomy
<ul>
<li style="font-weight: 400">Transoral endoscopic thyroidectomy</li>
<li style="font-weight: 400">Endoscopic thyroidectomy via breast or axillary approach</li>
</ul>
</li>
<li style="font-weight: 400">Who is suitable for transoral endoscopic thyroid surgery?</li>
<li style="font-weight: 400">Symptoms after transoral endoscopic thyroid surgery</li>
<li style="font-weight: 400">How many days of recovery after transoral endoscopic thyroid surgery?</li>
<li style="font-weight: 400">Preparation before transoral endoscopic thyroid surgery</li>
<li style="font-weight: 400">Postoperative care guidelines</li>
</ul>
Summary of transoral endoscopic thyroid surgery: A new scarless option
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<h2>Why undergo thyroid surgery (Thyroidectomy)?</h2>
Thyroidectomy is a treatment for abnormal thyroid gland function. Surgery is necessary in many cases, with doctors considering the cause and symptoms of the patient as follows:
<ul>
<li style="font-weight: 400">Presence of a nodule in the thyroid gland Thyroid nodules can be benign tumors or thyroid cancer that require surgery to remove the nodule. 
</li>
</ul>
Nodules are round or oval in shape, located at the front of the neck. Patients can feel or clearly see the lump on the neck. Thyroid nodules are more common in women than men, with a ratio of about 4:1. The chance of a thyroid nodule being cancerous is approximately 5–10%.
<ul>
<li style="font-weight: 400">Goiter (Enlarged thyroid) When the thyroid gland enlarges enough to compress the trachea or esophagus, causing difficulty breathing, swallowing, hoarseness, affecting daily life, breathing difficulties, and possibly risk of malignancy. Surgery to remove the thyroid mass is necessary for treatment.</li>
<li style="font-weight: 400">Hyperthyroidism In cases where medication is ineffective or patients cannot tolerate side effects of the drugs.</li>
<li>Chronic thyroiditis In some severe cases that do not respond to medication, thyroid surgery may be an appropriate treatment.</li>
</ul>
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Types of surgical treatment for thyroid nodules
The main types of thyroid surgery are:
<ul>
<li>Open thyroidectomy (traditional neck incision)</li>
<li>Endoscopic thyroidectomy via transoral scarless approach</li>
</ul>
Each method has different advantages and disadvantages. Doctors will consider the treatment method based on the characteristics of the nodule and severity of symptoms. The details of thyroid treatment methods are as follows:
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<h2>Open thyroidectomy (neck incision)</h2>
Open thyroidectomy is the traditional method that doctors are familiar with and have used for a long time. The advantage is that the surgeon can clearly see the surgical area and can remove nodules or part of the thyroid of any size. However, the disadvantage is that there is a neck scar, which in some cases may develop into a raised or keloid scar, potentially affecting the patient&#8217;s confidence. Recovery time is longer and there may be pain at the wound site.
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<h2>Endoscopic thyroidectomy</h2>
Endoscopic thyroidectomy is surgery performed using a high-resolution endoscope inserted through the armpit or mouth. It is a thyroid surgery method with a high safety standard.
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<h2>How many types of thyroid surgery are there?</h2>
There are several types of thyroid surgery, classified by technique and extent of surgery as follows:
<ol>
<li style="font-weight: 400">Hemi thyroidectomy/Lobectomy Removal of one side of the thyroid gland, suitable for nodules located on only one side.</li>
<li style="font-weight: 400">Subtotal thyroidectomy Removal of almost the entire thyroid gland, leaving some thyroid tissue.</li>
<li style="font-weight: 400">Near-total thyroidectomy Removal of nearly all thyroid tissue, leaving only the posterior capsule. Usually used in cases of hyperthyroidism unresponsive to medication or radioactive iodine therapy.</li>
<li style="font-weight: 400">Total thyroidectomy Complete removal of the thyroid gland, commonly used in thyroid cancer or nodules on both sides.</li>
</ol>
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<h2>Transoral endoscopic thyroidectomy</h2>
Transoral endoscopic thyroidectomy without visible scars (Transoral Endoscopic Thyroidectomy Vestibular Approach; TOETVA) is surgery performed through the lower lip and lower gum using an endoscope and special instruments inserted into the neck area.
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This is the latest surgical technique that has been developed, widely accepted, and popular worldwide. Surgeons can perform the procedure more conveniently, easily, and accurately using the endoscope, which reduces surgery time, minimizes pain, and allows faster recovery.
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The surgery uses a small, high-resolution camera to assist, resulting in small incisions located inside the lower lip: one 1.5 cm incision in the center and two 0.5 cm incisions on each side. This makes transoral endoscopic thyroidectomy the only method that leaves no visible scars on the skin (Scarless Thyroidectomy).
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<h2>Advantages of transoral endoscopic thyroid surgery</h2>
<ul>
<li>No external scars, resulting in better quality of life after surgery</li>
<li>Able to remove both thyroid lobes simultaneously</li>
<li>Provides good treatment outcomes and safety comparable to open thyroidectomy</li>
</ul>
Which thyroid surgery should you choose? Currently, transoral endoscopic thyroid surgery is popular and a standard treatment method that reduces the risk of surgical complications. The surgery time is short, recovery is fast, scarless, and causes only mild pain.
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<h2>Who is suitable for transoral endoscopic thyroid surgery?</h2>
Transoral endoscopic thyroid surgery is suitable for patients with the following characteristics:
<ul>
<li style="font-weight: 400">Patients with small to medium-sized thyroid nodules (not exceeding 2-3 cm)</li>
<li style="font-weight: 400">Patients with benign tumors or early-stage thyroid cancer (tumor size less than 2 cm and no lymph node metastasis in the neck)</li>
<li style="font-weight: 400">Patients who have never had neck surgery before</li>
<li style="font-weight: 400">Those who value cosmetic outcomes and do not want neck scars</li>
<li style="font-weight: 400">Patients in good general health who can tolerate general anesthesia</li>
<li style="font-weight: 400">Patients with good oral health and no oral infections</li>
<li style="font-weight: 400">Patients who have never undergone radiation therapy to the neck</li>
<li style="font-weight: 400">Patients without hyperthyroidism</li>
</ul>
<h2></h2>
<h2>Symptoms after transoral endoscopic thyroid surgery</h2>
After transoral endoscopic thyroid surgery, patients may experience pain around the lips and chin, swelling of the lips, and temporary numbness of the lower lip, which gradually improves and resolves within 1-3 weeks. Additionally, patients may feel tightness or a foreign body sensation in the neck or hoarseness, which may be caused by swelling or minor injury to the vocal nerve. This is very rare and usually resolves within 1 week.
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<h2></h2>
<h2>How many days of recovery after transoral endoscopic thyroid surgery?</h2>
<ul>
<li style="font-weight: 400">Hospital stay for 2-3 days for observation; if no abnormalities are found, the patient can go home</li>
<li style="font-weight: 400">Recovery at home for 5-10 days without wound care, as the sutures will dissolve within 30 days</li>
<li style="font-weight: 400">Able to return to daily activities faster than open neck surgery</li>
<li style="font-weight: 400">Some patients may have mild lip swelling, which resolves within 1-2 weeks</li>
</ul>
<h2></h2>
<h2>Preparation before transoral endoscopic thyroid surgery</h2>
After the doctor diagnoses and recommends transoral endoscopic thyroid surgery, preparation before surgery includes:
<ul>
<li style="font-weight: 400">Inform the doctor of medical history, illnesses, regular medications, and drug allergies</li>
<li style="font-weight: 400">Health check-up to assess readiness, including blood tests, urine tests, ECG, chest X-ray, and other tests as advised by the doctor</li>
<li style="font-weight: 400">Fasting from food and water for at least 6-8 hours before surgery due to general anesthesia (to prevent aspiration during anesthesia)</li>
<li style="font-weight: 400">Patients should be in good health, without colds or acute respiratory infections before surgery</li>
<li style="font-weight: 400">Generally, patients will be admitted to the hospital one night before surgery for preparation</li>
</ul>
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<h2>Postoperative care guidelines</h2>
<ul>
<li style="font-weight: 400">After surgery, patients can eat soft foods for 2-3 days, then resume normal diet</li>
<li style="font-weight: 400">Take antibiotics as prescribed by the doctor for 1 week</li>
<li style="font-weight: 400">Patients can bathe and clean themselves normally after surgery</li>
<li style="font-weight: 400">Avoid loud voice or shouting after surgery</li>
<li style="font-weight: 400">Avoid spicy or very hot foods; eat soft, easy-to-swallow foods</li>
<li style="font-weight: 400">Avoid coughing, sneezing, or forceful clearing of phlegm; gently spit out phlegm</li>
<li style="font-weight: 400">Avoid straining during bowel movements, heavy lifting, or strenuous exercise for at least 1 week</li>
<li style="font-weight: 400">After 1 week, start exercises for the mouth and neck to prevent scar tissue formation in the neck</li>
</ul>
&nbsp;
<h2>Transoral endoscopic thyroid surgery: A new scarless option</h2>
Transoral endoscopic thyroid surgery uses precise medical instruments and technology. It is considered a modern and highly effective surgical method. It is increasingly popular due to its safety, short recovery time, and absence of visible external scars.
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For thyroid patients seeking scarless endoscopic surgery, Phyathai 3 Hospital is ready to provide treatment with transoral endoscopic thyroidectomy (Transoral Endoscopic Thyroidectomy Vestibular Approach; TOETVA)
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Care is provided by specialized surgeons with advanced medical equipment, offering continuous postoperative care and follow-up to improve patients&#8217; quality of life.

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