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New thyroid surgical technique a ‘game-changer,’ Yale-New Haven doctor says

Updated: Sep 23, 2019


*This is excerpted from an original article at New Haven Register. Click here to be taken to the original article.*


NEW HAVEN >> A “game-changer” of a surgical technique allows doctors to operate on the thyroid without leaving a visible scar, according to Dr. Robert Udelsman of Yale-New Haven Hospital, who learned the surgery in Thailand.

The surgeon approaches the thyroid through the inside of the lower lip and it is just as effective as the traditional approach, Udelsman said Friday, just after completing his fourth such surgery in a week. “I think this is going to be a very big deal,” he said. “This is going to change thyroid surgery and parathyroid surgery.”

The thyroid is a butterfly-shaped gland that sits on the windpipe, below the Adam’s apple. The hormones it produces affect metabolism, growth and other functions. Reasons for thyroid surgery include nodules on the gland and cancer.

Traditionally surgery is via the neck, but Dr. Angkoon Anuwong of Bangkok developed the technique through the inside of the lip, called the vestibular approach, for cultural reasons. “Asian women really don’t want neck incisions because they consider it an invasion of their beauty,” Udelsman said. “From the patient’s perspective the ability to avoid a scar is a very big deal.”

Anuwong “is a colleague and friend of mine,” Udelsman said. “He showed me his presentation and I wasn’t convinced.” So Udelsman went to Bangkok, “Number one, to make sure he’s the real deal. ... Number two, to make sure the patients were doing well ... and then finally I wanted to ask the question, could we extrapolate his techniques and bring them back to the United States.”

Udelsman said Anuwong has done 300 of the vestibular thyroid surgeries and “I’ve done 5,000 thyroidectomies through the conventional approach.”

Anuwong came to Yale-New Haven this week to advise and consult on the first surgeries — Udelsman performed four and his colleague, Dr. Tobias Carling, did three. “I have no question we could have done it without him but the expertise he brought to the table made it better for our patients,” Udelsman said.

He said he expects to do 150 to 200 of the surgeries per year. “I think this thing is going to explode,” he said, while acknowledging that it requires specialized training. “This is not an easy operation,” he said. He said he’s grateful to his team and his patients for helping him launch the procedure in the United States.

Suzette Coady of Wallingford, a nurse with Trinity Home Health Services, said she was “getting better each minute” after having surgery Thursday. “When they first told me about it, I was a little apprehensive of the surgery,” she said, but she had faith in Udelsman, who recently operated on her father. “He said I was a good candidate so I decided to go with it and I think it’s a beautiful procedure for people who don’t want scars on their neck.”

Coady said she had nodules on the right side of her thyroid, which was removed. Despite stitches inside her mouth, she said she’s been able to eat since the surgery.

Sonia Camacho of Meriden, an assembler at Assa Abloy in Berlin, had a more complicated surgery — she had a cancerous thyroid removed as well as nearby lymph glands.

“They took everything out and they did a great job. It was way (more) comfortable this way than the way they did it before,” she said. “I’m very happy with the operation and I’m very comfortable that I get to go home two days after the operation.”

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