Non-endoscopic Minimally Invasive Thyroid Surgery

Abstract

Surgical techniques such as minimally invasive thyroid surgery and minimally invasive parathyroidectomy (MIP) have become part of daily endocrine surgical practice.

The three most commonly utilised approaches for thyroid surgery have become minimally invasive video-assisted thyroidectomy (MIVAT), minimal invasive thyroid surgery through a direct lateral mini-incision approach (MITS) or a central mini-incision approach. The major application of this surgical approach is the diagnostic excision of solitary thyroid nodules with atypical follicular cytology or excision of toxic thyroid nodules. In relation to the diagnostic excision of atypical solitary nodules, MITS should be seen as an investigative procedure positioned between fine-needle aspiration biopsy (FNAB) and conventional standard thyroidectomy achieved through a 5–6-cm incision. MITS follows the same principles as a conventional thyroid surgical procedure but is performed with less trauma of access. It uses a capsular dissection and requires identification of the laryngeal nerves and parathyroid glands. The simple MITS operative setup combined with its low costs has made it an attractive alternative treatment option to conventional thyroidectomy.