Response to the letter: Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA): Pioneers's Point of View

Dear Editors and Colleagues

We have examined with attention the comments of the letter to the Editor in regards to our recently published article (¹), and want to thank its authors for their interest in our work.

After evaluating it, we would like to re-emphasize that have very different points of view, indeed!

Two aspects deserve to be highlighted:

1. We strongly believe that any new complication event which was added by this new technique, thus not being ever observed in traditional and conventional thyroidectomy, must not ever be considered as “minor complication”.

2. We positively do not consider that the technique presented by your group should be called “minimally invasive.” As a matter of fact, the TOETVA involves extensive soft tissue manipulation, as well as the need to use gas insufflation (which was long time ago abandoned, when the endoscopic thyroidectomies were initially described) and a significant increase ein operative time, compared to the traditional and conventional thyroidectomy

Last, but not least, there have been some serious complications, some even life-threatening, which have not been mentioned.

Therefore, looking from a bioethical approach, we encourage you to participate in a multi-institutional prospective peer-reviewed trial to offer a final and sound conclusion concerning the feasibility of TOETVA in Brazil. Until then, these procedures must be considered experimental, and its execution restricted to centers involved in this afore mentioned protocol.

REFERENCE

• ¹
  Tincani A, Lehn C, Cernea C, Queiroz E, Dias F, Walder F, et al. Transoral thyroidectomy: A reflexive opinion on the technique. Arch Endocrinol Metab. 2021;65(3):396-9.

Publication Dates

• Publication in this collection
  08 Dec 2021
• Date of issue
  Nov-Dec 2021

History

• Received
  26 Sept 2021
• Accepted
  09 Nov 2021