Foley Balloon Facilitates Creation of Working Space in Transoral Thyroidectomy.

ABSTRACT

BACKGROUND: Transoral thyroidectomy via the vestibular approach retains no scars in the body surface and is a good option for patients indicated for thyroidectomy but with cosmetic concerns. However, the working space of this procedure is relatively small and is also difficult to create compared with that of other remote-access thyroidectomy procedures. METHODS: In this study, we first created a tract from the chin to the sternal notch, after which a Foley catheter with stylet was inserted through the middle oral incision. Sequential balloon insufflations were performed to dilate the entire subplatysmal tunnel. RESULTS: After Foley catheter dilatation, the subplatysmal space was larger, and subsequent trocar insertion became much easier. With the help of a balloon compressing the surrounding tissue, hemostasis was secured and a clearer tissue plane could be identified for subsequent sharp dissection. CONCLUSIONS: Foley balloon dilatation is a simple, effective, and low-cost technique that overcomes the difficulty in creation of working space during the initial stage and can be applied to all transoral thyroidectomy procedures.