World Journal of Surgery

, Volume 35, Issue 3, pp 543–551 | Cite as

Endoscopic Minimally Invasive Thyroidectomy (eMIT): A Prospective Proof-of-Concept Study in Humans

  • Thomas WilhelmEmail author
  • Andreas Metzig



We have developed a new approach for endoscopic minimally invasive thyroidectomy (eMIT) in anatomical studies. Safety and feasibility were demonstrated in an animal study and then the eMIT technique was applied for the first time successfully in humans on the 18 March 2009.


In a prospective study, we performed this eMIT technique on eight patients suffering from nodular change of the thyroid gland. All patients were evaluated regarding recurrent laryngeal nerve function, intra- and postoperative complications, and postoperative outcome, particularly with respect to swallowing disorders.


A total thyroidectomy and a partial resection were performed in four cases each. In three cases, a conversion to open surgery was necessary due to specimen size. No local infection at the incision site or within the cervical spaces occurred within the direct postoperative course. No intraoperative bleeding necessitating conversion to open surgery was observed. In one case, a permanent palsy of the right recurrent laryngeal nerve was noted. Voice function and breathing were not affected. Paresthesia of the mental nerve did not occur in all patients and in those in which it did occur, it resolved within 3 weeks. Mean follow-up time was 10.9 months.


The experimental development of the eMIT technique has led to its first clinical application in humans. In this prospective proof-of-concept study in humans, the thyroid gland was reached via the transoral endoscopic approach in an anatomically defined layer without any relevant damage to vessels. Limitations to this technique are determined by specimen volume (up to 30 ml) and nodule size (up to 20 mm).


Thyroid Gland Recurrent Laryngeal Nerve Harmonic Scalpel Mental Nerve Suspensory Ligament 
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.


Conflicts of interest

Dr. Thomas Wilhelm and Dr. Andreas Metzig have no conflicts of interest or financial ties to disclose.


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Copyright information

© Société Internationale de Chirurgie 2010

Authors and Affiliations

  1. 1.Department of Otolaryngology, Head/Neck and Facial Plastic SurgeryHELIOS Klinikum BornaBornaGermany
  2. 2.Department of General, Visceral, Minimally Invasive and Vascular SurgeryHELIOS Klinikum BornaBornaGermany

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