Minimally Invasive Video-Assisted versus Minimally Invasive Nonendoscopic Thyroidectomy

Abstract

Minimally invasive video-assisted thyroidectomy (MIVAT) and minimally invasive nonendoscopic thyroidectomy (MINET) represent well accepted and reproducible techniques developed with the main goal to improve cosmetic outcome, accelerate healing, and increase patient's comfort following thyroid surgery. Between 2007 and 2011, a prospective nonrandomized study of patients undergoing minimally invasive thyroid surgery was performed to compare advantages and disadvantages of the two different techniques. There were no significant differences in the length of incision to perform surgical procedures. Mean duration of hemithyroidectomy was comparable in both groups, but it was more time consuming to perform total thyroidectomy by MIVAT. There were more patients undergoing MIVAT procedures without active drainage in the postoperative course and we also could see a trend for less pain in the same group. This was paralleled by statistically significant decreased administration of both opiates and nonopiate analgesics. We encountered two cases of recurrent laryngeal nerve palsies in the MIVAT group only. MIVAT and MINET represent safe and feasible alternative to conventional thyroid surgery in selected cases and this prospective study has shown minimal differences between these two techniques.

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

“…Although reduced postoperative pain could not be considered as an additional advantage of MIVAT over CT (28), this advantage has been demonstrated objectively (29). 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).…”

Application of minimal invasive technique for thyroidectomy without remote access in locally advanced thyroid carcinoma with gross extra-thyroidal extension

“…Thyroid carcinomas proven by fine needle aspiration biopsy (FNAB) were considered ineligible to MIT [ 15 ]. However, recently, paradigm for treatment of thyroid carcinoma has been changed; thyroid carcinomas requiring hemi-thyroidectomy are considered eligible to MIT and many studies revealed MIT with or without remote access were safe and applicable for thyroid carcinoma requiring hemi-thyroidectomy [ 3 , 5 , 15 ]. With remote access (robot-assisted or endoscopic assisted or video-assisted), MIT is recognized to be very effective in the treatment of thyroid carcinoma regarding to safety and cosmetic outcome [ [16] , [17] , [18] , [19] ].…”

“…Ferzli et al first reported MIT with tough 2.5 cm cervical incision [ 2 ]. The goals of minimally invasive approaches are better cosmetic results with small neck scar, decreasing postoperative pain and neck discomfort, and shortening of hospital stay periods without postoperative complications [ 3 ]. Recently, MIT is useful and famous technique that is being applied to thyroid carcinoma.…”

Minimally Invasive Hemithyroidectomy Using a Mini Incision over the Upper Pole of Thyroid Swelling

“…Kocher in 1909, pioneered what is today known as the conventional thyroidectomy [1]. The goal for the surgeon is to remove the whole gland or its specific part, preserving inferior and superior laryngeal nerves and parathyroid glands, while achieving safe hemostasis mainly by ligating superior and inferior thyroid arteries [2]. Since Gagner et al described endoscopic approach to the parathyroid glands, various techniques have been described and popularized for thyroid surgery [3].Minimally invasive video assisted thyroidectomy(MIVAT)was introduced by Miccoli et al [4,5]who reported significant reduction in postoperative pain and better cosmetic results.…”