A Novel Connector for Intraoperative Nerve Monitoring Probes in Endoscopic Thyroidectomy: Comparative Efficacy and Preclinical Evaluation in a Porcine Model

Background: This study aimed to develop a connector that adapts standard endoscopic instruments into functional nerve stimulator probes. Methods: The connector underwent engineering validation in a laboratory and preclinical testing using a porcine model. A handheld standard stimulator probe served as the control. The experimental group consisted of a long monopolar probe and two connector-adapted probes. Recurrent laryngeal nerve (RLN) and vagus nerves were stimulated to compare the efficacy and safety of the adapted probes with the standard probe. Results: The connector, when coupled to endoscopic instruments, did not show a statistically significant difference in electromyographic (EMG) amplitude at 1 mA stimulation compared with the standard probe. Safety analysis showed no significant hemodynamic effects. Conclusion: This proof-of-concept study demonstrates that the developed connector, when paired with endoscopic instruments, enables reliable nerve identification and preservation during endoscopic thyroid surgery, with favorable efficacy and safety profiles.