Benign Thyroid Anomaly, Treated Kindly
A 55 year old female with left thyroid solitary nodule was found to be
Euthyroid on investigation. Further FNAC procedure revealed the
benign nature of nodule. She had a history of controlled hypertension.
The patient was planned for a scarless surgery of thyroid
(Hemithyroidectomy). The oral cavity of the patient was washed with
saline and betadine. Endotracheal intubation was done through the
nasal route. The approach was through the inferior vestibule of the oral
cavity where the ports were placed and included one midline 10 mm
camera port and two lateral 5 mm working ports. The operative field
was insufflated with carbon dioxide which provided us with easier
access. The sub-platyssmal plane was entered and dissected. The deep
fascia was opened in the midline and strap muscles retracted. The
isthmus of the thyroid gland was identified and divided.
The superior and inferior pedicles on the left side were identified and
divided by ultra scission. Recurrent laryngeal nerve was identified and
preserved. Haemostasis was secured. The left lobe was brought out
through the oral cavity using an endobag. The deep fascia was closed
using absorbable sutures and the vestibular port sites were closed in
layers using absorbable sutures.
Patient had minimal post operative lower lip oedema which subsided in
24 hours. Patient had no pain and was discharged the day after surgery
without any pain or scar. The follow-up revealed that patient had no
discomfort / disfigurement.
This is a Natural Orifices Transoral Endoscopic Surgery (NOTES), an
excellent technique for dealing with benign thyroid disorder.