Scarless thyroid surgery improves nerve and parathyroid protection but raises operative demands

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Key Considerations in Choosing Between Scarless (TOETVA) and Minimally Invasive (MINET) Thyroidectomy: This infographic summarizes the main factors guiding surgical choice between TOETVA (transoral endoscopic thyroidectomy vestibular approach) and MINET (minimally invasive nonendoscopic thyroidectomy). Credit: National Taiwan University

A new study led by National Taiwan University Hospital (NTUH) researchers shows that while scarless thyroid surgery preserves delicate structures better, it requires longer operative time, higher costs, and may compromise specimen integrity.

A large-scale study from National Taiwan University Hospital, published in JAMA Surgery, compared two minimally invasive  techniques: the scarless transoral endoscopic thyroidectomy vestibular approach (TOETVA) and minimally invasive nonendoscopic thyroidectomy (MINET).

The team analyzed 720 patients between 2021 and 2023, using propensity score matching to compare 210 patients in each group.

TOETVA offered better protection of nerves and  and left no visible neck scar, a feature valued by patients. However, it required nearly twice the operative time, was associated with higher early pain, a greater risk of specimen disruption, and hospital costs about 70% higher than MINET.

"These findings provide robust evidence to guide patients and ," says first author Dr. Ting-Chun Kuo. "Scarless  offers clear benefits but also important trade-offs."

"Our study underscores the importance of individualized patient selection and shows how large-scale, data-driven research can shape future surgical standards worldwide," adds corresponding author, Dr. Ming-Hsun Wu.

To see article on Medical Xpress: https://medicalxpress.com/news/2025-09-scarless-thyroid-surgery-nerve-parathyroid.html

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