3D Printed Patient-Specific Device Significantly Improved Safety in Patient Receiving Transoral Endoscopic Thyroidectomy

More than 52,000 adults are diagnosed of Thyroid cancer in the United States every year. It is the most common cancer in women from twenty to 34 years old. Major treatment involves surgery plus radioactive iodine ablation in certain condition. Traditional thyroidectomy are performed through a one inch transverse incision over the anterior low neck. The scar is apparent especially in patients with keloid-prone skin.

Transoral Endoscopic Approach for Thyroidectomy is an cosmetic appealing surgical technique for treating thyroid cancer. Instead of removing the cancerous thyroid through the incision on the anterior neck, which is obvious, surgeons remove the cancerous thyroid through a small incision in the mouth. No observable scar can be seen after the surgery.

However, this technique is heavily technical dependent. One of the common complication is mental nerve injury, causing low lip parathesia. Patients feel numbess, sometimes pain around the low lip region, impairing quality of life. The rate of mental nerve injury was reported to be as high as 75% in the initial period of robotic-assisted TOETVA.

A recent collaborative study (Printing a Three-Dimensional Patient-Specific Safety Device for Reducing the Potential Risk of Mental Nerve Injury During Transoral Thyroidectomy) conducted by the Department of Surgery and 3D Printing Center at Taipei Veterans General Hospital, Taipei, Taiwan showed that a patient-specific safety device greatly reduced complication risk. The team at Taipei Veterans General Hospital creates patient-specific protector (the inlet for surgical devices through incision) by high-resolution Facial CT scan. The protector fits with the patients’ teeth perfectly creating a firm foundation, while the lateral margin of the protector act as a barrier between surgical device and mental nerve, preventing intraoperative nerve injury.

According to the study, from March 2017 to March 2019, none of the 66 cases received Thyroidectomy transoral endoscopic thyroidectomy vestibular approach (TOETVA) suffered from mental nerve injury.

Through close collaboration between surgical and design team, 3D Printed Patient-specific safety device could be a sustainable and valuable service for patients receiving Transoral endoscopic thyroidectomy.