title: Natural Orifice Total Transtracheal Endoscopic Thyroidectomy Surgery: First Reported Experiment.
abstract: BACKGROUND
  Natural orifice translumenal endoscopic surgery (NOTES(®); American Society for Gastrointestinal Endoscopy [Oak Brook, IL] and Society of American Gastrointestinal and Endoscopic Surgeons [Los Angeles, CA]) is an improvement in surgical interventions. In this study we developed an innovative transtracheal endoscopic thyroidectomy technique and explored its feasibility in animal models.
  
  
  METHODS
  Transtracheal endoscopic thyroidectomy was performed in anesthetized dogs and pigs. The endoscope was advanced into the pretracheal space via a longitudinal incision on the anterior tracheal wall. Hemithyroidectomies and partial lobectomy were performed using special double-lumen endotracheal tubes and conventional endoscopic instruments. The tracheal wall incision was closed using absorbable sutures, and the animals were sacrificed at Day 5 postsurgery.
  
  
  RESULTS
  Hemithyroidectomy and partial thyroidectomy were successfully performed on pigs and dogs. The average operative time for each model was 69.4 minutes. No significant complications were encountered during surgery.
  
  
  CONCLUSIONS
  The transtracheal endoscopic thyroidectomy technique is feasible and has the potential to be an alternative method for other types of thyroid surgeries.
authors.affiliation: 1 Department of Hepatobiliary Surgery, Qilu Hospital of Shandong University , Shandong, China .
authors.forename: Enyu
authors.initials: E
authors.lastname: Liu
authors.affiliation: 2 Institute of Laparoscopic Minimally Invasive Surgery, Qilu Hospital of Shandong University , Shandong, China .
authors.forename: Abdul
authors.initials: A
authors.lastname: Qadir Khan
authors.affiliation: 1 Department of Hepatobiliary Surgery, Qilu Hospital of Shandong University , Shandong, China .
authors.forename: Jun
authors.initials: J
authors.lastname: Niu
authors.affiliation: 3 Hepatic Oncology, Jiangxi Provincial Tumor Hospital , Jiangxi, China .
authors.forename: Zongquan
authors.initials: Z
authors.lastname: Xu
authors.affiliation: 1 Department of Hepatobiliary Surgery, Qilu Hospital of Shandong University , Shandong, China .
authors.forename: Cheng
authors.initials: C
authors.lastname: Peng
mesh_terms: D000818:Animals; D004285:Dogs; D005240:Feasibility Studies; D005260:Female; D008297:Male; D057605:Natural Orifice Endoscopic Surgery / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D061646:Operative Time; D013537:Sutures; D013552:Swine; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods*; D014140:Tracheotomy / Q000009:adverse effects / Q000379:methods