４．Thyroid Surgery in East Asia

Among various techniques of remote access thyroidectomy, these days, the transoral approach is getting popularized due to the advantages of less surgical morbidity and excellent cosmesis.Transoral thyroidectomy may include a sublingual approach, oral vestibular approach, and combined approach according to the incision site as shown here.The transoral vestibular approach with CO2 insufflation is currently the most popular procedure.The invasiveness of the transoral approach in creating a working space is less than that of other remote access approaches.Postoperative cosmesis is potentially better than other procedures.This approach enables surgeons to perform bilateral total thyroidectomy efficiently.In comparing the transoral robotic and endoscopic procedures, the endoscopic technique is superior in terms of operative time and cost-effectiveness.However, the robotic approach has crucial advantages of excellent surgical view, innovative instruments, and improved surgical skills.Several studies have recently revealed that the surgical outcomes of the transoral vestibular approach are acceptable and comparable to the conventional approach.However, there are some unusual complications, such as mental nerve injury, surgical site infection, CO2 embolism, skin perforation, and bruising.Compared to conventional thyroidectomy, significant advantages of transoral thyroidectomy are superior cosmesis and better preservation of postoperative voice outcomes.In this session, I would like to present the current advances and functional and oncologic outcomes in transoral robotic thyroidectomy.