Surgical Equipment, Supplies, and Setup for Transoral Thyroid and Parathyroid Surgery via the Vestibular Approach

Transoral thyroid and parathyroid surgery is made possible with the use of endoscopic and robotic technology through a novel, scarless approach in the lower vestibulum of the oral cavity (lower lip). The evolution of thyroid surgery from a large incision in the neck to remote-access, scarless approaches has in large part been made possible by advancements in laparoscopic and robotic technology, devices, and accessories. While these tools have been used for remote-access thyroid surgery from various approaches from the chest, axilla, and neck areas, there are unique challenges with the transoral approach that require familiarity with the requisite instrumentation. In this chapter, we highlight pre- and postoperative aspects of transoral endoscopic thyroidectomy vestibular approach (TOETVA) in patient management, operative room setup, and instrumentation. As with any new procedure, proper instrumentation and familiarity with all elements of the operation are of paramount importance.