Abstract:Objective: To evaluate the feasibility of natural orifice translumenal endoscopic (NOTES) surgery through the oral vestibule for benign thyroid disease. Methods: From October 2013 to September 2014, 6 patients with benign nodular thyroid disease underwent NOTES surgery through the oral vestibule. Three patients had a solitary right thyroid nodule, and 3 patients had a solitary left thyroid nodule; the nodule was cystic in one case, solid in 4 cases, and mixed in one case. The diameters of the nodules ranged from 1 to 4 cm. One patient was diagnosed as thyroid adenoma and 5 patients were diagnosed as nodular goiter before operation. Results: NOTES thyroidectomy through the oral vestibule was performed successfully in the 6 patients, with an average operative time of 122 (100–150) min and average intraoperative blood loss of 30 (10–40) mL. Of the patients, 5 cases underwent unilateral partial thyroidectomy, one case underwent unilateral subtotal thyroidectomy, and none required open conversion. Postoperative pathological examination revealed thyroid adenoma in one case and nodular goiter in 5 cases. No severe complications such as nerve or parathyroid injury occurred after operation. The average length of hospital stay was 8.2 (8–10) d, and there was no local recurrence during the follow-up period of 3 to 13 months. Conclusion: NOTES thyroidectomy through the oral vestibule for benign thyroid disease is feasible, and has a hidden incision and satisfactory cosmetic results.