Transoral endoscopic thyroidectomy vestibular approach

Baylor St. Luke’s Medical Center is the only hospital in the state of Texas, and one of five high-volume centers in the United States, to offer the transoral endoscopic thyroidectomy vestibular approach (TOETVA) that allows for a scarless thyroid and parathyroid removal. This is one of the most innovative and unique operations in all of surgery and one of the most exciting developments in thyroid and parathyroid care in the last decade.
Dr. Raymon Grogan, endocrine surgery section chief at Baylor St. Luke’s Medical Center and associate professor at Baylor College of Medicine, has completed over 200 TOETVA procedures. Baylor St. Luke’s Medical Center is one of three high-volume academic thyroid- and parathyroid-focused surgical practices in the U.S. that studied 1,000 consecutive thyroid and parathyroid operations, determining more than half to be eligible for transoral endoscopic thyroidectomy vestibular approach (TOETVA).
“The most common scarless thyroid and parathyroid techniques currently used in the United States are transoral endoscopic thyroidectomy vestibular approach for thyroidectomy (TOETVA) and transoral endoscopic parathyroidectomy vestibular approach for parathyroidectomy (TOEPVA).”
Raymon Grogan, MD
With the incision length of 2 cm or less, TOETVA is considered minimally invasive or remote access. The procedure is very unique because the surgeon goes through the inner lip to remove the thyroid, which leaves no sign of external scarring. The procedure also protects the parathyroid as an additional benefit. Patient satisfaction after the operation is extremely high.
Raymon Grogan, MD

Section Chief, Endocrine Surgery, Baylor St. Luke’s Medical Center


Leading Texas in multidisciplinary endocrinology and endocrine surgery clinic integration

The Thyroid and Parathyroid Center at the Dan L Duncan Comprehensive Cancer Center is one of the only fully integrated multidisciplinary clinics of its kind in Texas. Combining endocrinologists and endocrine surgeons in the same clinic ensures fluid communication, faster diagnosis times, and prompt operation availability. This combined with surgical expertise that results in optimized operating times—meaning less time under general anesthesia—and even same-day discharges create a patient experience that is unrivaled in the state of Texas. The Thyroid and Parathyroid multidisciplinary team at Baylor St. Luke’s Medical Center is comprised of experts in complex cases for both benign and malignant thyroid, parathyroid, and adrenal disorders and has complication rates well below national gold standards.

Unparalleled diabetes and thyroid cancer research

The Section of Endocrinology, Diabetes and Metabolism at Baylor College of Medicine supports a robust biomedical research base. The Diabetes Research Center explores a vast range of diseases and conditions but focuses its efforts in four key areas: diabetes, metabolism, and nutrition research; the area of diabetes pathobiology and pathophysiology; the area of molecular lipid, glucose, and energy homeostasis; and the area of molecular endocrinology.

One additional area of research is in thyroid cancer. Almost half the population in the United States has a nodule in the thyroid, however when evaluating these nodules for cancer nearly 20% of fine needle aspiration (FNA) biopsies are found to be indeterminate in diagnosis based on cytological evaluation. Led by Dr. James Suliburk, endocrine surgeon at Baylor St. Luke’s Medical Center and associate professor and chief of endocrine surgery at Baylor College of Medicine, a new alternative uses metabolic analysis by desorption electrospray ionization mass spectrometry (DESI-MS) imaging for direct analysis and diagnosis of follicular cell-deprived neoplasia tissues and FNA biopsies. During the latest clinical study, 68 patients were tested, and the new MassSpec Pen returned a false positive only 1 time out of 10.
“With this next-generation test, we can provide thyroid cancer diagnoses faster and with more precision than current techniques.”
James Suliburk, MD

The next step is a two-year validation study including over 1,000 patients in the U.S., Brazil, and Australia.

James W. Suliburk
James Suliburk, MD

Endocrine Surgeon, Baylor St. Luke’s Medical Center

Associate Professor and Chief of Endocrine Surgery, Baylor College of Medicine 

The Pituitary Center at Baylor Medicine

The largest and busiest in Texas, the Pituitary Center cares for all pituitary-related disorders, including tumors of the pituitary and sellar region. The multidisciplinary team approach includes both endocrinologists and neurosurgeons working to develop and place patients on clinical trials aimed at establishing new therapies for pituitary tumors.
Led by Dr. Ali Jalali, neurosurgeon at Baylor St. Luke’s Medical Center, and Dr. Sara Bedrose, endocrinologist at Baylor St. Luke’s Medical Center and associate professor at Baylor College of Medicine, the team remains experts in minimally invasive endoscopic pituitary surgery and non-surgical treatment, including CyberKnife®.
Dr. Ali Jalali
Surgical Director of the Pituitary Center at Baylor St. Luke’s Medical Center
Patient Story

Cynthia's story: living cancer and scar-free

Cynthia was familiar with her papillary thyroid cancer, because it had affected several members of her family before. She knew her cancer was treatable with surgery, but she had witnessed the side effects. She wanted to avoid trouble with her voice and the scar on her throat so she began to hunt for scarless thyroid surgery. She chose to visit Dr. Raymon Grogan, section chief of endocrine surgery at Baylor St. Luke’s Medical Center, one of the only doctors in the U.S. that performs transoral thyroidectomy, or TOETVA—a scarless thyroid surgery that allows for the safe and total removal of the thyroid or parathyroid glands without any external scarring to the neck. Shortly after surgery, Cynthia was informed her cancer was entirely removed with negative surgical margins.

Cynthia Doyle

Mechanism reprograms endocrine-resistant breast cancer to become metastatic

Researchers at Dan L Duncan Comprehensive Cancer Center, in partnership with Baylor College of Medicine and Harvard Medical School, have unveiled a new mechanism to help explain how endocrine-resistant breast cancer acquires metastatic behavior, opening the possibility of new therapeutic strategies. These findings reveal details of the intricate mechanism FOXA1 triggers to induce metastatic behavior in endocrine-resistant breast cancer, which other reports have suggested also is present in other types of cancer, such as prostate and pancreatic cancer. In addition, the findings support further exploration of the possibility that inhibiting HIF-2a or other enhancer that controls the expression of many genes in endocrine therapy-resistant breast cancer could be translated into effective therapeutic strategies.