Objective:

To determine the feasibility of a hand-side matching strategy in transoral endoscopic thyroidectomy via the vestibular approach (TOETVA) and its impact on surgical outcomes.

Approach:

• Study Design: A single-center retrospective cohort study involving 298 patients who underwent unilateral TOETVA from August 2016 to August 2020.
• Grouping: Patients were divided into NDH-TOETVA (non-dominant-hand) and DH-TOETVA (dominant-hand) based on the surgeon's hand dominance relative to the operative side.
• Surgical Technique: Standardized surgical techniques and perioperative care were followed, with specific hand usage for key maneuvers based on the group.
• Statistical Analysis: Utilized SPSS 26.0 for data analysis, including t-tests for continuous variables and χ2 tests for categorical variables.
• Learning Curve: Operative time was analyzed using cumulative sum (CUSUM) learning curves to identify phases of learning.
• Propensity Score Matching: 1:1 greedy nearest-neighbor matching was used to compare outcomes between groups while controlling for confounding variables.

Key Findings:

• The study analyzed perioperative variables and complications associated with hand-side matching in TOETVA.

Interpretation:

Limitations:

• Single-center study may limit generalizability.
• Retrospective design may introduce selection bias.

Conclusion:

Hand-side matching in TOETVA is a feasible strategy.