World Journal of Surgery

, Volume 32, Issue 7, pp 1333–1340 | Cite as

Minimally Invasive Video-Assisted Thyroidectomy for Benign Thyroid Disease: An Evidence-Based Review

  • Paolo Miccoli
  • Michele N. MinutoEmail author
  • Clara Ugolini
  • Roberta Pisano
  • Alessandra Fosso
  • Piero Berti



A decade after nearly all surgical disciplines developed minimally invasive techniques, the first report of a single case of minimally invasive thyroidectomy was published. Minimally invasive video-assisted thyroidectomy (MIVAT) is now considered the most widely practiced and most easily reproducible minimally invasive procedure for thyroidectomy. The aim of this review was to analyze the treatment of benign thyroid diseases by MIVAT.


A systematic evidence-based literature review focusing on three questions was carried out. Additional data were obtained on the basis of our personal experience. (1) Are minimally invasive procedures indicated in the treatment of thyroid diseases? (2) Is MIVAT a safe technique and what are the demonstrated advantages? (3) Since different thyroid diseases may be treated by MIVAT, is it of any value in the treatment of benign thyroid diseases?


MIVAT can be considered an appropriate treatment of some thyroid diseases; it represents a safe procedure with the same incidence of complications as traditional surgery, and also has advantages in terms of both cosmetic result and postoperative distress.


In spite of an increasing trend toward performing more extensive procedures other than thyroidectomy alone during videoscopic procedures, the current literature seems to reaffirm that the main and safest indication for MIVAT is benign disease.


Papillary Thyroid Carcinoma Benign Disease Multinodular Goiter Completion Thyroidectomy Benign Thyroid Disease 
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.


  1. 1.
    Hüscher CS, Chiodini S, Napolitano C et al (1997) Endoscopic right thyroid lobectomy. Surg Endosc 11(8):877PubMedCrossRefGoogle Scholar
  2. 2.
    Yeung HC, Ng WT, Kong CK (1997) Endoscopic thyroid and parathyroid surgery. Surg Endosc 11(11):1135PubMedCrossRefGoogle Scholar
  3. 3.
    Miccoli P, Berti P, Conte M et al (1999) Minimally invasive surgery for thyroid small nodules: preliminary report. J Endocrinol Invest 22(11):849–851PubMedGoogle Scholar
  4. 4.
    Shimizu K, Akira S, Jasmi AY et al (1999) Video-assisted neck surgery: endoscopic resection of thyroid tumors with a very minimal neck wound. J Am Coll Surg 188(6):697–703PubMedCrossRefGoogle Scholar
  5. 5.
    Ikeda Y, Takami H, Sasaki Y et al (2000) Endoscopic neck surgery by the axillary approach. J Am Coll Surg 191(3):336–340PubMedCrossRefGoogle Scholar
  6. 6.
    Gagner M, Inabnet WB 3rd (2001) Endoscopic thyroidectomy for solitary thyroid nodules. Thyroid 11(2):161–163PubMedCrossRefGoogle Scholar
  7. 7.
    Nakano S, Kijima Y, Owaki T et al (2002) Anterior chest wall approach for video-assisted thyroidectomy using a modified neck skin lifting method. Biomed Pharmacother 56 Suppl 1:96s–99sPubMedCrossRefGoogle Scholar
  8. 8.
    Brunaud L, Zarnegar R, Wada N et al (2003) Incision length for standard thyroidectomy and parathyroidectomy: when is it minimally invasive? Arch Surg 138(10):1140–1143PubMedCrossRefGoogle Scholar
  9. 9.
    Henry JF (2006) Minimally invasive surgery of the thyroid and parathyroid glands. Br J Surg 93(1):1–2PubMedCrossRefGoogle Scholar
  10. 10.
    Miccoli P, Berti P, Frustaci GL et al (2006) Video-assisted thyroidectomy: indications and results. Langenbecks Arch Surg 391(2):68–71PubMedCrossRefGoogle Scholar
  11. 11.
    Terris DJ (2007) Minimally invasive thyroidectomy: an emerging standard of care. Minerva Chir 62(5):327–333 PubMedGoogle Scholar
  12. 12.
    Sackett DL (1989) Rules of evidence and clinical recommendations on the use of antithrombotic agents. Chest 95(Suppl):2–4CrossRefGoogle Scholar
  13. 13.
    Heinrich S, Schafer M, Rousson V et al (2006) Evidence-based treatment of acute pancreatitis: a look at established paradigms. Ann Surg 243:154–168PubMedCrossRefGoogle Scholar
  14. 14.
    Miccoli P, Berti P, Raffaelli M et al (2001) Comparison between minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: a prospective randomized study. Surgery 130(6):1039–1043PubMedCrossRefGoogle Scholar
  15. 15.
    Miccoli P, Elisei R, Materazzi G et al (2002) Minimally invasive video-assisted thyroidectomy for papillary carcinoma: a prospective study of its completeness. Surgery 132(6):1070–1073; discussion 1073–1074PubMedCrossRefGoogle Scholar
  16. 16.
    Terris DJ, Bonnett A, Gourin CG et al (2005) Minimally invasive thyroidectomy using the Sofferman technique. Laryngoscope 115(6):1104–1108PubMedCrossRefGoogle Scholar
  17. 17.
    Miccoli P, Bellantone R, Mourad M et al (2002) Minimally invasive video-assisted thyroidectomy: multi-institutional experience. World J Surg 26(8):972–975PubMedCrossRefGoogle Scholar
  18. 18.
    Ikeda Y, Takami H, Sasaki Y et al (2004) Are there significant benefits of minimally invasive endoscopic thyroidectomy? World J Surg 28(11):1075–1078PubMedCrossRefGoogle Scholar
  19. 19.
    Lombardi CP, Raffaelli M, Princi P et al (2005) Safety of video-assisted thyroidectomy versus conventional surgery. Head Neck 27(1):58–64 PubMedCrossRefGoogle Scholar
  20. 20.
    Ujiki MB, Sturgeon C, Denham D et al (2006) Minimally invasive video-assisted thyroidectomy for follicular neoplasm: is there an advantage over conventional thyroidectomy? Ann Surg Oncol 13(2):182–186PubMedCrossRefGoogle Scholar
  21. 21.
    Hegazy MA, Khater AA, Setit AE et al (2007) Minimally invasive video-assisted thyroidectomy for small follicular thyroid nodules. World J Surg 31(9):1743–1750PubMedCrossRefGoogle Scholar
  22. 22.
    Perigli G, Cortesini C, Qirici E et al (2008) Clinical benefits of minimally invasive techniques in thyroid surgery. World J Surg 32(1):45–50PubMedCrossRefGoogle Scholar
  23. 23.
    Terris DJ, Seybt MW, Elchoufi M et al (2007) Cosmetic thyroid surgery: defining the essential principles. Laryngoscope 117(7):1168–1172PubMedCrossRefGoogle Scholar
  24. 24.
    Del Rio P, Berti M, Sommaruga L et al (2007) Pain after minimally invasive videoassisted and after minimally invasive open thyroidectomy—results of a prospective outcome study. Langenbecks Arch Surg. 2007 Oct 2; [Epub ahead of print]Google Scholar
  25. 25.
    Berti P, Materazzi G, Galleri D et al (2004) Video-assisted thyroidectomy for Graves’ disease: report of a preliminary experience. Surg Endosc 18(8):1208–1210PubMedCrossRefGoogle Scholar
  26. 26.
    Maeda S, Uga T, Hayashida N et al (2006) Video-assisted subtotal or near-total thyroidectomy for Graves’ disease. Br J Surg 93(1):61–66PubMedCrossRefGoogle Scholar
  27. 27.
    Miccoli P, Berti P, Frustaci GL et al (2006) Video-assisted thyroidectomy: indications and results. Langenbecks Arch Surg 391(2):68–71PubMedCrossRefGoogle Scholar
  28. 28.
    Lombardi CP, Raffaelli M, Princi P et al (2006) Video-assisted thyroidectomy: report on the experience of a single center in more than four hundred cases. World J Surg 30(5):794–800PubMedCrossRefGoogle Scholar
  29. 29.
    Lombardi CP, Raffaelli M, Princi P et al (2006) Video-assisted thyroidectomy: report of a 7-year experience in Rome. Langenbecks Arch Surg 391(3):174–177PubMedCrossRefGoogle Scholar
  30. 30.
    Terris DJ, Chin E (2006) Clinical implementation of endoscopic thyroidectomy in selected patients. Laryngoscope 116(10):1745–1748PubMedCrossRefGoogle Scholar
  31. 31.
    Terris DJ (2007) Minimally invasive nonendoscopic thyroidectomy. Otolaryngol Head Neck Surg 137(2):362PubMedCrossRefGoogle Scholar
  32. 32.
    Miccoli P, Minuto MN, Ugolini C et al (2007) Intrathyroidal differentiated thyroid carcinoma: tumor size-based surgical concepts. World J Surg 31(5):888–894PubMedCrossRefGoogle Scholar
  33. 33.
    Miccoli P, Elisei R, Donatini G et al (2007) Video-assisted central compartment lymphadenectomy in a patient with a positive RET oncogene: initial experience. Surg Endosc 21(1):120–123PubMedCrossRefGoogle Scholar
  34. 34.
    You NY, Wells SA (2007) Role of surgeons in clinical trials for thyroid cancer. World J Surg 31:987–995PubMedCrossRefGoogle Scholar
  35. 35.
    AACE (1996) Clinical practice guidelines for the diagnosis and management of thyroid nodules. Endocr Pract 2:78–84Google Scholar
  36. 36.
    Mazzaferri EL (1999) Thyroid carcinoma practice guidelines. Oncology 13(Suppl. 11A, NCCN Proceedings):391–442Google Scholar
  37. 37.
    White ML, Gauger PG, Doherty GM (2007) Central lymph node dissection in differentiated thyroid cancer. World J Surg 31(5): 895–904PubMedCrossRefGoogle Scholar
  38. 38.
    Kitagawa W, Shimizu K, Akasu H et al (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(6):990–994PubMedCrossRefGoogle Scholar
  39. 39.
    Miccoli P, Elisei R, Donatini G et al (2007) Video-assisted central compartment lymphadenectomy in a patient with a positive RET oncogene: initial experience. Surg Endosc 21(1):120–123PubMedCrossRefGoogle Scholar
  40. 40.
    Miccoli P, Materazzi G, Berti P (2007) Minimally invasive video-assisted lateral lymphadenectomy: a proposal. Surg Endosc. 2007 Aug 25; [Epub ahead of print] Google Scholar
  41. 41.
    Lombardi CP, Raffaelli M, Princi P et al (2007) Minimally invasive video-assisted functional lateral neck dissection for metastatic papillary thyroid carcinoma. Am J Surg 193(1):114–118PubMedCrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2008

Authors and Affiliations

  • Paolo Miccoli
    • 1
  • Michele N. Minuto
    • 1
    Email author
  • Clara Ugolini
    • 1
  • Roberta Pisano
    • 1
  • Alessandra Fosso
    • 1
  • Piero Berti
    • 1
  1. 1.Department of SurgeryUniversity of PisaPisaItaly

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