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World Journal of Surgery

, Volume 26, Issue 8, pp 972–975 | Cite as

Minimally Invasive Video-assisted Thyroidectomy: Multiinstitutional Experience

  • Paolo Miccoli
  • Rocco Bellantone
  • Michel Mourad
  • Martin Walz
  • Marco Raffaelli
  • Piero Berti

Minimally invasive video-assisted thyroidectomy (MIVAT) was described in 1998. In this study we collected the experience of four third-level referral centers that adopted this technique. A total of 336 patients (279 females, 57 males) were selected for MIVAT. Selection criteria were thyroid volume <15 ml, nodules not exceeding 3.5 cm of diameter, and an absence of thyroiditis, previous neck surgery, or previous irradiation. The procedure, totally gasless, is carried out through a 15 mm central incision above the sternal notch. Dissection is performed under endoscopic vision using conventional and endoscopic instruments. The mean operating time was 69.4 ± 30.6 minutes for lobectomy (range 20–150 minutes) and 87.4 ± 43.5 minutes for total thyroidectomy (range 30–220 minutes). The mean postoperative stay was 1.9 ± 0.8 days. Postoperative complications were 7 transient and 1 definitive recurrent nerve palsies and 11 cases of hypoparathyroidism (9 transient, 2 definitive). Conversion to open surgery was necessary in 15 patients (4.5%). This study confirms in a large number of cases the safety and feasibility of MIVAT, even in different surgical settings where similar results were achieved. The complication rate was not different from that of standard thyroidectomy. Although the operating time appears longer than with conventional procedures, the learning curve demonstrates a sharp decrease with increasing experience and the introduction of new technologies. The number of patients eligible for this approach remains low, thereby limiting its use, but it should be considered a valid option in selected surgical centers, offering some advantages to patients in terms of cosmetic results and postoperative distress.

Keywords

Thyroiditis Total Thyroidectomy Hypoparathyroidism Thyroid Volume Previous Irradiation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Société Internationale de Chirurgie 2002

Authors and Affiliations

  • Paolo Miccoli
    • 1
  • Rocco Bellantone
    • 2
  • Michel Mourad
    • 3
  • Martin Walz
    • 4
  • Marco Raffaelli
    • 1
  • Piero Berti
    • 1
  1. 1.Dipartimento di Chirurgia, Università degli Studi di Pisa, Via Roma 67, 56100 Pisa, ItalyITALY
  2. 2.Unità di Endocrinochirurgia, Università Cattolica di Roma, Via della Pineta Sacchetti, Rome, ItalyITALY
  3. 3.Services Transplantation Renale et Chirurgie Endocrinienne Cliniques, Universitaires Saint Luc, Avenue Hippocrate 10, 1200 Bruxelles, BelgiumBELGIUM
  4. 4.Center for Minimal Invasive Surgery, Kliniken Essen, Henricistrasse Mitte 92, 45136 Essen, GermanyGERMANY

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