Minimally invasive thyroid surgery, using various techniques including endoscopic and video-assisted have been reported. Thyroid surgery using a mini-incision over the upper pole of the thyroid, as a new technique is presented here. Methods: The study group comprised of 52 patients undergoing minimally invasive thyroid surgery (MITS) by open method during the period May 2005-May 2013. Data regarding patient demographics, indication for surgery, operation performed, nodule size, final pathology, and complications were recorded. The operation was carried out through a 1.5-2-cm incision placed directly over the upper pole of the swelling, and deepening the incision to visualize the superior pedicle. After ligating the superior pedicle, the finger is passed over the gland and separated from all sides. Then the thyroid is pulled up and the inferior pedicle accessed and ligated. Any bleeding points were taken care of and the wound was closed without drain. Results: Fifty two patients underwent MITS, 38 women and fourteen men. All the patients underwent hemi-thyroidectomy. The average measured incision size was 2. cm at the end of the procedure. The average nodule size was 3.2 cm, and the average thyroid lobe resected measured 4.5 cm in maximal length. Final pathology revealed follicular adenoma in51 patients and one thyroid cancer (follicular). There was one wound infection and one patient had temporary recurrent laryngeal nerve neurapraxia. Conclusion: Minimally invasive thyroid surgery with a minimal incision over the upper pole of thyroid swelling as an alternative to open thyroid surgery, using a standard cervical collar incision, is safe and feasible.

Minimally invasive thyroid surgery techniques (MIT) have the advantage of reduction of tissue trauma, early hospital discharge, and better neck wound cosmetic appearance, while maintaining the same surgical outcome as traditional thyroidectomy. In addition to MIT, methods of skin closure contribute to the overall aesthetic outcome and patient's satisfaction. Methods of skin closure depends largely on the surgeon's choice based upon the need for a rapid, economic, and reproducible technique. The aim of the study is to compare the quality of resulting scar at 6 weeks after mini-incision hemithyroidectomy with subcuticular absorbable sutures or no subcuticular or skin sutures for the closure of the incision. Methods. There are 102 patients undergoing mini-incision hemithyroidectomy. Fifty two patients were randomly assigned to closure with approximation of subcutaneous tissue and skin by bringing the wound edges together by pressing with forceps and the other 50 with subcuticular absorbable suture. Post-operatively patients were assessed for pain and it was observed that pain was less in group treated without skin or subcutaneous sutures. At 6 weeks, the scar was evaluated by the patient after viewing in the mirror and graded as 1-5. Results. Pain during the postoperative period was significantly less in patients without subcutaneous or skin sutures. Assessment of scar appearance by the patients showed a statistically significant difference in favor of no skin or subcutaneous suture (n=48) as compared to subcuticular suture (n=40). Conclusion. Incision closure of mini -incision hemithyroidectomy without subcuticular or skin sutures and only by approximation had less pain postoperatively as compared to subcuticular suture. Scar assessment by patients revealed better satisfaction by this method.

Abstract:Introduction: Open prostatectomy/adenoma enucleation remains a valuable surgical option in treating large obstructing prostates in patients with large gland volume. We report our series of retropubic prostatectomies with innovative methods to reduce the complications and lead to smooth recovery. Patients and Methods: A total of 75 patients with B PH were treated by retropubic prostatectomy from 2005 to 2015. Patient's demographical, clinical, pre-and postoperative data and final histology were recorded. 3 way Foley's catheter before surgery was kept in the bladder and haemostasis was obtained by applying traction over the prostatic fossa. Results: The mean weight of prostatic adenoma was 82 gm., the smallest being 70gm. and the largest 192gm. Only 2 patients required intra operative blood transfusion. The catheter was removed on the 5th post-operative day. 94% of the patients voided with a good stream with little discomfort after one week. only one patient had incontinence of urine which improved subsequently over a period of 6 to 8 weeks. There was no mortality and no reexploration for clot retention was required in any patient, Conclusion: Millin's prostatectomy popularized over half a century ago continues to be a valuable option for the surgical treatment of high-volume prostate glands with excellent outcomes for patients with innovative methods.