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New neck surgery leaves patient scar-free

A thyroid cancer patient has neck surgery that leaves no scar, in a new procedure and a first for Stanford surgeons.

Karina Torres was worried last year when she learned she had papillary thyroid cancer, but it didn't help to hear that surgery to treat the condition would leave a scar on the front of her neck.

The hair stylist, makeup artist and massage therapist had undergone surgery before and felt she had enough scars. "A scar on the neck -- that's something you can't really cover up," she said.

Torres, 44, traveled from her home in Fresno to Stanford Hospital to receive a second opinion from Dana Lin, MD, an assistant professor of surgery, about her tumor. Lin told her that the tumor was small, so Torres was a candidate for a new type of surgery: transoral thyroidectomy, meaning the thyroid could be removed through the mouth without leaving a visible scar.

I shared Torres' story in a recent Stanford Medicine article.

A Thai physician developed the transoral thyroidectomy in 2014; since then the procedure has spread to a handful of medical centers in the United States. Before performing surgery on Torres, Lin observed the procedure at the University of California, San Francisco, then practiced the technique on cadavers.

First Lin cut three holes inside Torres' lower lip, surgical ports through which she inserted a scope with a video camera on its end and two tools, one for grasping and one for cutting. The camera's images appeared on several screens in the operating room.

Watching the screens, Lin guided the tools under Torres' skin -- over her chin and down her neck to the thyroid gland. She cut away the left half of the gland, where the tumor lay; placed it in a little bag; and pulled the bag out through the port in the mouth.

Torres "did fantastically post-operatively," Lin said. "She had minimal pain and discomfort and was discharged the next day."

The benefit of having a transoral thyroidectomy is mostly the lack of scarring, Lin said. She added that data show the procedure is at least as safe as taking the traditional, through-the-neck route.

Recovering at home after the surgery, Torres said she was a little sore, but felt relieved that the surgery went well.

"I'm very grateful to not have a scar," she said. "I can't see myself wearing scarves all the time, especially in hot Fresno."

Photo by Steve Fisch

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