Langenbeck's Archives of Surgery

, Volume 391, Issue 2, pp 68–71

Video-assisted thyroidectomy: indications and results

  • Paolo Miccoli
  • Piero Berti
  • Gian Luca Frustaci
  • Carlo Enrico Ambrosini
  • Gabriele Materazzi
Current Concepts in Endocrine Surgery

DOI: 10.1007/s00423-006-0027-7

Cite this article as:
Miccoli, P., Berti, P., Frustaci, G.L. et al. Langenbecks Arch Surg (2006) 391: 68. doi:10.1007/s00423-006-0027-7

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.

Keywords

Endoscopic thyroidectomyVideo-assisted thyroidectomyMinimally invasive thyroid surgeryPapillary thyroid carcinomaRET gene mutation

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© Springer-Verlag 2006

Authors and Affiliations

  • Paolo Miccoli
    • 1
  • Piero Berti
    • 1
  • Gian Luca Frustaci
    • 1
  • Carlo Enrico Ambrosini
    • 1
  • Gabriele Materazzi
    • 1
  1. 1.Dipartimento di ChirurgiaUniversità di PisaPisaItaly