Transoral endoscopic thyroidectomy-vestibular approach: starting a program in an inner-city hospital

Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is quickly gaining popularity as the only truly scarless approach to central neck surgery. The literature reports more than 1,000 cases completed around the world. Starting a program incorporating this approach has obvious challenges in regards to surgeon training, building a team and recruitment of patients. We describe the methods of training and recruitment strategies used in the establishment of a transoral endoscopic thyroid program in an inner-city community hospital. In addition, we describe the demographics, nodule characteristics and operative times for our initial experience with 4 cases. These cases were performed successfully without any complications and great patient satisfaction. On review of the case load of the senior author we estimate that approximately 56% of our head and neck endocrine cases will be eligible for this approach in the future.