Abstract
Background and aims
Minimally invasive video-assisted thyroidectomy (MIVAT) was set up and introduced in our department in 1998. Its results, after an acceptable relapse, can now be evaluated, also speculating on new possible indications.
Patients and methods
The procedure is based on a unique incision in the central neck, 2 cm above the sternal notch, using small conventional retractors and needlescopic (2 mm) reusable instruments. Haemostasis is achieved by a harmonic scalpel. Patients, 833, underwent MIVAT since June 1998. There were 715 females and 118 males (ratio 4:1). Lobectomy was carried out in 323 (38.7%) patients, total thyroidectomy in 510 (61.2%) patients.
Results
Mean operative time of lobectomy was 36.2 min (range: 20–120); for total thyroidectomy, 46.1 min (30–130). Conversion to standard cervicotomy was required in 16 cases (1.9%); Operative complications were represented by transient monolateral recurrent nerve palsy in eight cases (0.9%), definitive monolateral recurrent nerve palsy in seven cases (0.8%). Twenty patients exhibited a hypoparathyroidism, which corresponds to 3.9% of total thyroidectomies performed, but only two showed permanent hypoparathyroidism (0.3%).
Conclusion
MIVAT can be considered a safe operation offering significant cosmetic advantages with possible new promising indications such as prophylactic thyroidectomy in rearranged during transfection (RET) gene mutation carriers. It is still limited to a minority of patients, in particular, in endemic goitre countries.
Similar content being viewed by others
References
Miccoli P, Berti P, Conte M, Bendinelli C, Marcocci C (1999) Minimally invasive surgery for small thyroid nodules: preliminary report. J Endocrinol Invest 22:849–851
Gagner M, Inabnet WB (2001) Endoscopic thyroidectomy for solitary thyroid nodules. Thyroid 11:161–163
Shimizu K, Akira S, Jasmi AY, Kitamura Y, Kitagawa W, Akasu H, Tanaka S (1999) Video-assisted neck surgery: endoscopic resection of thyroid tumors with a very minimal neck wound. J Am Coll Surg 188:697–703
Ohgami M, Ishii S, Ohmori T, Noga K, Furukawa T, Kitajima M (2000) Scarless endoscopic thyroidectomy: breast approach better cosmesis. Surg Laparosc Endosc Percutan Tech 10:1–4
Ikeda Y, Ikeda Y, Takami H, Sasaki Y, Kan S, Niimi M (2000) Endoscopic neck surgery by the axillary approach. J Am Coll Surg 191:336–340
Miccoli P, Berti P, Raffaelli M, Materazzi G, Baldacci S, Rossi G (2001) Comparison between minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: a prospective randomized study. Surgery 130:1039–1043
Bellantone R, Lombardi CP, Bossola M, Boscherini M, De Crea C, Alesina PF, Traini E (2002) Video-assisted vs conventional thyroid lobectomy: a randomized trial. Arch Surg 137(3):301–304
Ikeda Y, Takami H, Sasaki Y, Takayama J, Niimi M, Kan S (2002) Comparative studies of thyroidectomies: endoscopic surgery vs conventional open surgery. Surgical Endoscopy 16:1741–1745
Duh QY (2003) Presidential address: minimally invasive endocrine surgery-standard of treatment or hype? Surgery 134(6):849–857
Miccoli P, Elisei R, Materazzi G, Capezzone M, Galleri D, Pacini F, Berti P, Pinchera A (2002) Minimally invasive video assisted thyroidectomy for papillary carcinoma: a prospective study about its completeness. Surgery 132:1070–1074
Kitigawa W, Shimizu K, Akasu H, Tanaka S (2003) Endoscopic neck surgery with lymph node dissection for papillary carcinoma of the thyroid using a totally gasless anterior neck skin lifting method. J Am Coll Surg 196:990–994
Miccoli P, Materazzi G (2004) Minimally invasive, video-assisted thyroidectomy (MIVAT). Surg Clin North Am 84(3):735–741, Jun
Mourad M, Pugin F, Elias B, Malaise J, Coche E, Jamar F, Maiter D, Daumerie Ch, Squifflet JP (2002) Contributions of the video-assisted approach to thyroid and parathyroid surgery. Acta Chir Belg 102:323–327
Shimizu K, Kitagawa W, Akasu H, Hatori N, Hirai K, Tanaka S (2002) Video-assisted endoscopic thyroid and parathyroid surgery using a gasless method of anterior neck skin lifting: a review of 130 cases. Surg Today 32(10):862–868
Author information
Authors and Affiliations
Corresponding author
Electronic supplementary material
Below is the link to the electronic supplementary material.
(MPEG 36 mb)
Rights and permissions
About this article
Cite this article
Miccoli, P., Berti, P., Frustaci, G.L. et al. Video-assisted thyroidectomy: indications and results. Langenbecks Arch Surg 391, 68–71 (2006). https://doi.org/10.1007/s00423-006-0027-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00423-006-0027-7