Minimally invasive thyroid and parathyroid surgery is not a question of length of the incision

Henry, J. F.

doi:10.1007/s00423-008-0406-3

Cited by 88 publications

(77 citation statements)

References 40 publications

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“…Improved pain outcome was also demonstrated when MIVAT was compared to non-endoscopic mini-incision thyroidectomy (30,31). This reinforces the concept that surgical invasiveness is not only limited to the length of the incision but extends to every aspect of the procedure (32). The short incision in MIVAT is only a minor contributor to its minimal invasiveness which is mainly attributed to the targeted dissection offered by its direct access and endoscopic part.…”

Section: Mivat's Advantagessupporting

confidence: 58%

Minimally Invasive Video-Assisted Thyroidectomy (MIVAT) in the Era of Minimal Access Thyroid Surgery

Bakkar

Miccoli

2017

J Minim Invasive Surg Sci

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Background: In the era of minimal access thyroid surgery, the terms minimal access and minimally invasive are often used interchangeably and in most instances this is far from being accurate. The aim of this article is to examine the characteristics and potential of one of the first minimal access thyroid procedures described; minimally invasive video-assisted thyroidectomy (MI-VAT). Methods: The purpose of this article was obtained by almost two decades of experiences with the procedure at the authors' center, and a systemic literature review was undertaken of all available medical literature to evaluate available literature by conducting a PubMed search limited to articles originally written in English language between the years 1997 and 2016. The search was limited by using the terms: minimally invasive thyroid surgery, video-assisted, endoscopic, and robotic thyroidectomy. The procedure's design, radicality and safety, learning curve, cost, advantages and disadvantages were addressed. MIVAT's potential as a surgical tool for thyroid pathology was also addressed by evaluating its indications, contraindications, and limitations. Results: MIVAT is a gasless hybrid procedure that is comparable to conventional thyroidectomy (CT) in terms of radicality and safety, with the added advantage of reduced early postoperative voice and swallowing symptoms. MIVAT has a relatively rapid learning curve with an additional advantage over other minimal access procedures; the ability of being adopted by the low-volume surgeon at a cost and time comparable to CT, but with improved patient satisfaction. Furthermore, it is non-inferior to procedures free of a neck scar in terms of patient satisfaction. MIVAT's main drawback is that it is limited by its strict selection criteria. It is a viable treatment option for all types of thyroid pathologies. However, its role in therapeutic neck dissection remains to be validated. Conclusions: MIVAT is a safe and effective procedure which is obviously described in its name "minimally invasive". It seems that in the era of innovative technologies and scarless-in-the neck thyroid surgery, MIVAT is here to stay.

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Section: Mivat's Advantagessupporting

confidence: 58%

Minimally Invasive Video-Assisted Thyroidectomy (MIVAT) in the Era of Minimal Access Thyroid Surgery

Bakkar

Miccoli

2017

J Minim Invasive Surg Sci

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“…These lengths were chosen as previous studies have defined minimally invasive approaches as having incision lengths of 2.5-4.0 cm and conventional approaches as having incision lengths of 5.0-10.0 cm. 4,[10][11][12][13][14] The minimum limits of these ranges were chosen for the simulated scars' lengths as it was felt that this would be a more useful comparison than the upper limits or averages of these ranges.…”

Section: Experimental Designmentioning

confidence: 99%

“…[10][11][12] Enthusiasm to reduce the thyroidectomy scar has also led to the development of robotic thyroidectomy performed through a transaxillary approach. This robotic approach has been shown to have similar complication rates to the open approach, but is associated with increased operative time.…”

Section: Introductionmentioning

confidence: 99%

A paired comparison analysis of third-party rater thyroidectomy scar preference

et al. 2016

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Objective: To determine the length and position of a thyroidectomy scar that is cosmetically most appealing to naïve raters.Methods: Images of thyroidectomy scars were reproduced on male and female necks using digital imaging software. Surgical variables studied were scar position and length. Fifteen raters were presented with 56 scar pairings and asked to identify which was preferred cosmetically. Twenty duplicate pairings were included to assess rater reliability. Analysis of variance was used to determine preference.Results: Raters preferred low, short scars, followed by high, short scars, with long scars in either position being less desirable ( p < 0.05). Twelve of 15 raters had acceptable intra-rater and inter-rater reliability.Conclusion: Naïve raters preferred low, short scars over the alternatives. High, short scars were the next most favourably rated. If other factors influencing incision choice are considered equal, surgeons should consider these preferences in scar position and length when planning their thyroidectomy approach.

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“…MIP can be defined as the ability of the surgeon to perform traditional surgical procedures in novel ways to minimize the trauma of the surgical exposure [8,9]. Given the safety and high success rate of bilateral neck exploration, the potential advantages of MIP are: decreased operating times (OT), decreased hospitalization time, reduced level of physical invasiveness, and better cosmetic results [8].…”

Section: Introductionmentioning

confidence: 99%

Improvement of minimally invasive parathyroidectomy outcomes by real time ultrasonography performed by a surgeon and radiologist team.

et al. 2015

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Aims: Minimally invasive parathyroidectomy (MIP) has become the first line of treatment for primary hyperparathyroidism caused by solitary parathyroid adenoma. In order to increase the sensitivity of high-resolution ultrasonography (hUS), surgeon performed ultrasonography (SUS) has been increasingly used preoperatively. However, a radiologist and surgeon performing ultrasonography (RSUS) has not been a usual practice. In this study, we aimed to evaluate the clinical contribution of RSUS on MIP. Material and methods: From 2012 to 2014, a total of 30 consecutive patients (4 male, 26 female, mean age 48.87±14.52 years) with solitary parathyroid adenoma, were included in the study. All patients underwent preoperative hUS and Technetium-99m sestamibi scintigraphy. In patients, demographic characteristics, diagnostic tools used, levels of biochemical parameters, duration of operation, and length of hospital stay were recorded. Results: Adenomas were successfully localized by US in all patients and the surgical approach was determined according to this localization. Parathyroidectomy with MIP was successfully performed under local anesthesia in all patients. Mean operation time was 19.87±3.35 min. Postoperative PTH and calcium values were significantly decreased. All patients were discharged from the hospital in the same day. None of the patients had complications such as recurrent laryngeal nerve injury, hematoma, or injury to nearby organs. None of the patients had drains placed. Conclusions: Adenoma is well localized by US and thus, MIP can be completed under local anesthesia. US provides a very important clinical contribution to the success of MIP. In addition to these, RSUS helps in determining the location of the incision and the shortest way to achieve the lesion; therefore, it provides a small incision and shortens duration of the operation with a minimal dissection.

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Minimally invasive thyroid and parathyroid surgery is not a question of length of the incision

Cited by 88 publications

References 40 publications

Minimally Invasive Video-Assisted Thyroidectomy (MIVAT) in the Era of Minimal Access Thyroid Surgery

Minimally Invasive Video-Assisted Thyroidectomy (MIVAT) in the Era of Minimal Access Thyroid Surgery

A paired comparison analysis of third-party rater thyroidectomy scar preference

Improvement of minimally invasive parathyroidectomy outcomes by real time ultrasonography performed by a surgeon and radiologist team.

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