Introduction: Among the specific complications of operations on the organs of the neck, the main place is occupied by a violation of the mobility of the vocal cords. Thanks to the introduction of non-invasive methods for recording a signal from the vocal folds using intraoperative neuromonitoring (IONM), it became possible to assess the preservation of the laryngeal nerves, to avoid the development of bilateral paresis of the vocal cords, by assessing the preservation of nerves during the operation. Objective: to develop a methodology for the implementation of intraoperative neuromonitoring during video endosurgical operations on thyroid gland. Materials and methods: On the basis of the surgical department No. 1 of the Central Clinical Hospital, Administrative departments of the President of the Russian Federation, Clinic of Faculty Surgery and Oncology, Saratov State Medical University V.I. Razumovsky” during May 2013-April 2020, 412 patients with various pathologies of the thyroid glands underwent videoendosurgical interventions. Results: We performed the following surgical interventions for thyroidectomy - 112, hemithyroidectomy - 145, subtotal resection - 47 cases. The volume of the thyroid gland was from 17 to 200 ml. At the same time, we try to adhere to a certain algorithm of actions, taking into account the fact that during the operation, irritation of the laryngeal nerves can cause a variety of problems that will give an incorrect answer to these reasons: anesthesiology factors, incorrect operation of the active electrode, technical errors of the operation itself. Conclusions: Intraoperative neuromonitoring for videoendoscopic interventions provides the ability to visualize all anatomical structures incomparable with open operations, reduces the risks of trauma to the laryngeal nerves, allows you to monitor the signal in real time, improves the quality of intraoperative navigation and the safety of surgical intervention.

Objective: the development and assessment of endoscopic hemithyroidectomy technique improving visualization of anatomical structures and excluding the so-called conflict of instruments in the operative field. Materials and methods. We analyzed the treatment results of 103 patients who underwent hemithyroidectomy with endoscopic or traditional approaches during 2014-2018 at the S.R. Mirotvortsev Hospital of Saratov State Medical University. In terms of approach mode, patients were divided into two groups. The compression syndrome, functional autonomy of a thyroid, and results of a punch biopsy were indications to operation. Results. Unilateral vocal cord paralysis (UVCP) was diagnosed in one patient after traditional intervention, diminishing after 1.5 months; and in three patients after endoscopic hemithyroidectomy, diminishing anywhere between 7 days and 1.5 months. Signs of hypoparathyroidism were not found in any of the patient groups. There were no complications associated with the introduction of carbon dioxide. No conversion was required in any of the cases. Conclusion. Development, application and assessment of a new endoscopic hemithyroidectomy technique, which proved itself feasible, safe and provisioning highly esthetic outcome were conducted.

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В связи с внедрением новых хирургических технологий и усовершенствованием технического обеспечения операций существенно изменился подход к лечению больных с хирургической патологией. Принципы минимально инвазивных оперативных вмешательств нашли свое место в хирургическом лечении различных органов и систем. Хирургия щитовидной и околощитовидных желез не явилась исключением в данном случае, несмотря на то что минимально инвазивные вмешательства не всегда могут быть названы менее травматичными в сравнении с