Minimally invasive video-assisted thyroidectomy

BACKGROUND: In this paper we describe the results of our personal technique for minimally invasive video-assisted thyroidectomy (MIVAT). METHODS: Sixty-seven patients were selected for MIVAT. Selection criteria were nodule size less than 30 mm, thyroid volume less than 20 mL, no thyroiditis, no previous neck surgery or irradiation. The procedure, totally gasless, is carried out through a 15-mm central incision above the sternal notch. Dissection is performed under endoscopic vision, using conventional and endoscopic instruments. RESULTS: We performed 51 lobectomies and 15 total thyroidectomies. Mean operative time was 73.6 minutes for lobectomy and 109.6 minutes for total thyroidectomy. Conversion to open procedure was required twice (3%). We observed 2 cases of transient postoperative hypocalcemia and 1 case of transient recurrent laryngeal nerve palsy. The cosmetic result was considered excellent by most patients. CONCLUSIONS: MIVAT is safe and feasible. The indications are limited at present, but the results are encouraging, and we are optimistic about the future expansion of its applicability.