The effect of carbon dioxide insufflation during transoral endoscopic thyroidectomy via a vestibular approach on internal jugular vein pressure changes : is there a safer alternative?

Abstract

Transoral endoscopic thyroidectomy via a vestibular approach (TOETVA) is a minimally invasive surgical approach to the thyroid gland which has been shown to be relatively safe but comes with a number of novel complications. Some studies show that a sudden increase in intra-jugular pressure leads to an increase in intra-ocular pressure. These changes are particularly important in glaucoma patients since small changes may have a damaging effect on their vision. Our group has suggested that using a device to modify the standard TOETVA into a gasless 1 might lead to less changes in intra-jugular pressure.