SUN-428 Rural India Embracing Advanced Techniques in MIS:- A Series of 20 Cases of Thyroid Surgeries by Transoral Endoscopic Thyroidectomy-Vestibular Approach (TOETVA) Technique with Respect to Acceptance of Progressive Surgeries Using Advanced Technologies, Techniques by Rural Patients and it’s Safety & Feasibility in Small Setup Hospital in Rural India

Aims & Objectives Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) an alternative surgical technique for thyroid surgery is slowly gaining widespread popularity. Majority of TOETVA surgeries are performed in Tertiary Care institutes. It’s safety & Feasibility in small setup hospitals has not been reported until now. The key challenges in Indian Rural healthcare sector are Lack of Quality Infrastructure, Dearth of qualified medical functionaries and NonAccess to basic medicines and medical facilities thwarts its reach to population in rural India. Indian Health Care sector is a self-pay market. Lack of awareness & affordability being a challenge with patients they remain apprehensive in acceptance of Advanced Technology or newer Techniques. This series is an attempt to study A shift in acceptance of progressive surgeries using Advanced Technologies & Techniques by Rural Patients and its Safety & Feasibility in Smaller operative setups in rural India. Methods Proper patient selection along with proper instrumentation & OT setup helped complete the procedures without any major complication. Advanced Instrumentation along with essential Operation Theatre setup were utilised for performing Total of 20 TOETVA procedures. For successful execution of TOETVA surgeries extensive Training Programs were furnished to equip stakeholder teams with respective Skill, Knowledge & Attitude sets. Organisational SWOT Analysis & Competency mapping contributed to strategise a helping approach to Educate & Influence stakeholders. Results Total 20 patients were operated by TransOral Endoscopic Thyroidectomy - Vestibular (TOETVA) Technique from May 2018 till September 2019. Three SubTotal Thyroidectomies & 16 Hemithyroidectomies were performed. One patient was operated for Thyroglossal cyst. Increased awareness about a need to Improve on competence of Empathy & Accountability, Pursuit of Quality Care & Inculcating Cost-Effective use of the results of relevant research in regular functions. Conclusions There is a noticeable paradigm Shift in acceptance of rural patients as well as of rural paramedical staff that these surgeries which require Advanced Technology & Innovative Techniques are easily Accessible & Executable without undue cost burden with utmost safety at their own vicinity even in the small setup hospitals. This study aids to recommend Feasibility & Safety of TOETVA even for small setup of hospitals in Rural India.