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Minimally Invasive Video-Assisted Thyroidectomy (MIVAT)

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Book cover Minimally Invasive Therapies for Endocrine Neck Diseases

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Abstract

In the last decade, several techniques for minimally invasive thyroidectomy have been proposed. Among them, mini-invasive video-assisted thyroidectomy (MIVAT) has been the most widely diffused and practised. Traditional indications for MIVAT are small thyroid nodules (<35 mm) in normal thyroid gland (estimated volume <20 ml), no history of previous neck surgery or irradiation, no suspicious cytology, no evidence of suspicious lymph-node involvement. Nonetheless, in the last years in referral centres after an adequate period of training, the indication for its use gradually widened including patients who had undergone previous video-assisted neck procedures and patients with small differentiated thyroid carcinoma (DTC). Recently, following the demonstration of oncological completeness of the procedure, some authors have even extended the indications for MIVAT to include the intermediate-risk class of DTC. The procedure is performed via a single central 1.5–2.0 cm skin incision between the cricoid cartilage and the sternal notch. It reproduces all the steps of conventional surgery. The endoscope is only a tool that allows performing the same traditional operation by a smaller skin incision, thanks to the optical magnification. MIVAT demonstrated to be, in large series, a reproducible, safe technique, with the same incidence of complications and results as conventional surgery but with significant advantages in terms of both cosmetic result and postoperative distress. These characteristics made it a valid and validate option and in selected cases the preferable one for the surgical treatment of thyroid diseases.

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Authors and Affiliations

  1. Unità Operativa di Chirurgia Endocrina CIC, Università Cattolica del Sacro Cuore, Roma, Largo Agostino Gemelli, 8, Rome, 00168, Italy

    Annamaria D’Amore

  2. Unità Operativa di Chirurgia Endocrina E Metabolica, Università Cattolica del Sacro Cuore, Roma, Largo Agostino Gemelli, 8, Rome, 00168, Italy

    Carmela De Crea, Marco Raffaelli, Celestino Pio Lombardi & Rocco Bellantone

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  1. Annamaria D’Amore
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  2. Carmela De Crea
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  3. Marco Raffaelli
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  4. Celestino Pio Lombardi
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  5. Rocco Bellantone
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Correspondence to Annamaria D’Amore .

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Editors and Affiliations

  1. Chief of Endocrine Surgery Unit, Policlinico Gemelli – CIC, Università Cattolica del Sacro Cuore, Rome, Milano, Italy

    Celestino Pio Lombardi

  2. Chief of Istituto Semeiotica Chirurgica, Chief of Endocrine and Metabolic Surgery Unit, Policlinico Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy

    Rocco Bellantone

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D’Amore, A., De Crea, C., Raffaelli, M., Lombardi, C.P., Bellantone, R. (2016). Minimally Invasive Video-Assisted Thyroidectomy (MIVAT). In: Lombardi, C., Bellantone, R. (eds) Minimally Invasive Therapies for Endocrine Neck Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-20065-1_10

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  • DOI: https://doi.org/10.1007/978-3-319-20065-1_10

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