Langenbeck's Archives of Surgery

, Volume 392, Issue 4, pp 413–416 | Cite as

The eligibility of MIVA approach in thyroid surgery

  • Massimo RuggieriEmail author
  • Andrea Straniero
  • Mariapia Genderini
  • Massimino D’Armiento
  • Angela Fumarola
  • Pierpaolo Trimboli
  • Patrizia Gargiulo
Current Concepts in Endocrine Surgery



Thyroid size, by preoperative ultrasound evaluation, is a very important criterion of minimally invasive video-assisted thyroidectomy (MIVAT) exclusion because the working space provided by the technique is limited. The aim of this work is to verify the suitability of MIVAT and its applicability in clinical practice in patients with a thyroid volume up to 50 ml.


From January 2003 to February 2006, 33 patients were selected for MIVAT. A completely gas-less procedure was carried out through a central skin incision performed “high” between the cricoid and jugular notch.


The skin incision performed was from 20 to 35 mm (mean 24.88 mm ± 2.74) for different thyroid sizes. We obtained in all cases excellent results about patients cure rate and comfort, few cases of postoperative pain, and attractive cosmetic results.


In this study, we demonstrated that the MIVAT, for thyroids up to 50 ml in volume, is feasible and safe. This procedure allows more patients, who would have been excluded before, to take advantage of this minimally invasive approach with good cosmetic results, highly regarded by young female patients, and reduced paresthetic consequences.


Minimally invasive video-assisted thyroidectomy Thyroid surgery Video-assisted surgery MIVAT Eligibility of MIVAT 



The authors thank R. Spano, F. Di Leo, M. Pucci, B. Renzetti, and A. Cassandra for nursing assistance, in the operating theater, to patients listed in this study.


  1. 1.
    Gagner M (1996) Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism. Br J Surg 83:875PubMedCrossRefGoogle Scholar
  2. 2.
    Shimizu K (2001) Minimally invasive thyroid surgery. Best Pract Res Clin Endocrinol Metab 15:123–137PubMedCrossRefGoogle Scholar
  3. 3.
    Shimizu K, Akira S, Tanaka S (1998) Video assisted neck surgery: endoscopic resection of benign thyroid tumor aiming at scarless surgery on the neck. J Surg Oncol 69:178–180PubMedCrossRefGoogle Scholar
  4. 4.
    Ikeda Y, Takami H, Sasaki Y, Takayama J, Niimi M, Kan S (2002) Comparative study of thyroidectomies. Endoscopic surgery vs conventional open surgery. Surg Endosc 16:1741–1745PubMedCrossRefGoogle Scholar
  5. 5.
    Ikeda Y, Takami H, Tajima G, Sasaki Y, Takayama J, Kurihara H, Niimi M (2002) Direct mini-incision thyroidectomy. Biomed Pharmacother 56:60–63CrossRefGoogle Scholar
  6. 6.
    Ikeda Y, Takami H, Tajima G, Sasaki Y, Takayama J, Kurihara H, Niimi M (2002) Total endoscopic thyroidectomy: axillary or anterior chest approach. Biomed Pharmacother 56:72–78CrossRefGoogle Scholar
  7. 7.
    Ikeda Y, Takami H, Sasaki Y, Takayama J, Kurihara H (2004) Are there significant benefits of minimally invasive endoscopic thyroidectomy? World J Surg 28:1075–1078PubMedCrossRefGoogle Scholar
  8. 8.
    Ohgami M, Ishii S, Arisawa Y, Ohmori T, Noga K, Furukawa T, Kitajima M (2000) Scarless endoscopic thyroidectomy: breast approach for better cosmesis. Surg Laparosc Endosc Percutan Tech 10:1–4PubMedCrossRefGoogle Scholar
  9. 9.
    Miccoli P (2002) Minimally invasive surgery for thyroid and parathyroid diseases. Surg Endosc 16:3–6PubMedCrossRefGoogle Scholar
  10. 10.
    Miccoli P, Bellantone R, Mourad M, Walz M, Raffaeli M, Berti P (2002) Minimally invasive video-assisted thyroidectomy: multiistitutional experience. World J Surg 26:972–975PubMedCrossRefGoogle Scholar
  11. 11.
    Miccoli P, Berti P, Conte M, Bendinelli C, Marcocci C (1999) Minimally invasive surgery for thyroid small nodules: preliminary report. J Endocrinol Invest 22:849–851PubMedGoogle Scholar
  12. 12.
    Miccoli P, Berti P, Raffaeli M, Conte M, Materazzi G, Galleri D (2001) Minimally invasive video-assisted thyroidectomy. Am J Surg 181:567–570PubMedCrossRefGoogle Scholar
  13. 13.
    Miccoli P, Berti P, Raffaeli M, Materazzi G, Baldacci S (2001) Comparison between minimally invasive video-assisted thyroidectomy: a prospective randomised study. Surgery 130:1039–1043PubMedCrossRefGoogle Scholar
  14. 14.
    Miccoli P, Elisei R, Materazzi G, Capezzone M, Galleri D et al (2002) Minimally invasive video-assisted thyroidectomy for papillary carcinoma: a prospective study of its completeness. Surgery 132:1070–1074PubMedCrossRefGoogle Scholar
  15. 15.
    Mourad M, Pugin F, Elias B, Coche E, Squifflet JP et al (2002) Contributions of the video-assisted approach to thyroid and parathyroid surgery. Acta Chir Belg 102:323–327PubMedGoogle Scholar
  16. 16.
    Musella M, Lombardi S, Caiazzo P, Milone F, Di Palma R, De Franciscis S, Jovino R (2003) La chirurgia video-assistita della tiroide: note di tecnica e analisi dei risultati. Ann Ital Chir 1:3–5Google Scholar
  17. 17.
    Bellantone R, Lombardi C, Raffaeli M, Alesina P, De Crea C, Traini E, Salvatori M (2003) Video-assisted thyroidectomy for papillary thyroid carcinoma. Surg Endosc 17:1604–1608PubMedCrossRefGoogle Scholar
  18. 18.
    Bellantone R, Lombardi C, Raffaeli M, Boscherini M, De Crea C, Traini E (2002) Video-assisted thyroidectomy. J Am Coll Surg 194:610–614PubMedCrossRefGoogle Scholar
  19. 19.
    Lombardi C, Raffaeli M, Modesti C, Boscherini M, Bellantone R (2004) Video-assisted thyroidectomy under local anesthesia. Am J Surg 187:515–518PubMedCrossRefGoogle Scholar
  20. 20.
    Ruggieri M, Straniero A, Pacini F, Maiuolo A, Mascaro A, Genderini M (2003) Video-assisted surgery of the thyroid diseases. Eur Rev Med Pharmacol Sci 7:91–96PubMedGoogle Scholar
  21. 21.
    Ruggieri M, Straniero A, Pacini F, Maiuolo A, Mascaro A, Genderini M (2003) Comparison between video-assisted thyroidectomy and conventional thyroidectomy. Preliminary aspects. Policlinico J Surg 110:11–17Google Scholar
  22. 22.
    Ruggieri M, Straniero A, Genderini M, D’Armiento M, Gargiulo P, Fumarola A, Trimboli P (2005) The minimally invasive open video-assisted approach in surgical thyroid diseases. BMC Surg 5:9PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Massimo Ruggieri
    • 1
    Email author
  • Andrea Straniero
    • 1
  • Mariapia Genderini
    • 2
  • Massimino D’Armiento
    • 2
  • Angela Fumarola
    • 2
  • Pierpaolo Trimboli
    • 2
  • Patrizia Gargiulo
    • 3
  1. 1.Department of Surgery “Francesco Durante”University of Rome “La Sapienza”RomeItaly
  2. 2.Department of Experimental Medicine and Pathology, Chair of EndocrinologyUniversity of Rome “La Sapienza”RomeItaly
  3. 3.Department of Clinical SciencesUniversity of Rome “La Sapienza”RomeItaly

Personalised recommendations