Minimally invasive video-assisted thyroidectomy: experience of 200 cases in a single center

Abstract

IntroductionMinimally invasive techniques in thyroid surgery including video-assisted technique originally described by Miccoli have been accepted in several continents for more than 10 years.AimTo analyze our preliminary results from minimally invasive video-assisted thyroidectomy (MIVAT) and to evaluate the feasibility and effects of this method in a general department over a 4-year period.Material and methodsInitial experience was presented based on a series of 200 patients selected for MIVAT at the General Surgery Department of Yantai Yuhuangding Hospital affiliated with Qingdao University during the period from May 2008 to June 2012. The enrolling criteria were rigorously observed. An above sternal incision with average length of 2.5 cm (1.5–3.0 cm) was made. Clinicopathologic characteristics, postoperative pain, length of hospital stay, cosmetic results and complications were retrospectively analyzed.ResultsAll patients received general anesthesia. Thyroid unilateral lobectomy was successfully accomplished in 108 cases, total thyroidectomy in 84, and partial lobectomy in 8. Conversion to standard conventional thyroidectomy was required in 6 patients (3%) because of thyroiditis and bleeding. The mean lymph node yield of the cancer specimens was 3.6 per patient. Permanent unilateral recurrent laryngeal nerve (RLN) palsy occurred in 1 case (0.5%), transient unilateral RLN palsy in 6 patients (3.0%, complete recovery after 1–6 months), and transient hypocalcemia in 7 patients (3.5%). No definitive hypocalcemia was observed. No postoperative hematomas occurred. Postoperative pain was endurable. The cosmetic result was excellent in most cases.ConclusionsThe MIVAT is feasible and safe in selected patients, with better results comparable to conventional thyroidectomy. The MIVAT can also be performed in a general surgery department.

Minimally Invasive Video-Assisted Thyroidectomy: Analysis of Complications From a Systematic Review

“…Among these trials, 8 were randomized prospective (Table 1), 21-29 7 were nonrandomized (Table 2), 30-36 and 17 were uncontrolled (Table 3). 37-52 After a descriptive analysis of overall data was performed, a wide range of variability concerning the results can be observed.…”

How I Do It: New Dissector Device Allows for Effective Operative Field in Transoral Endoscopic Thyroid Surgery Using Vestibular Approach

“…With the minimally invasive, video-assisted thyroidectomy method there is still a 15- to 20-mm single incision at the neck. 16,17 The cosmetic result proved to be very good but limitations are the size of the specimen to remove, which should not be more than 30 mL. 8 ABBA seemed to be an advancement because of the missing scar on the neck.…”

Frequency of Post-Surgery Hypocalcaemia in Patients Undergoing Total Thyroidectomy

“…22 Researchers in the past have reported surgical techniques, parathyroid iatrogenic injury, gender, perioperative serum calcium level drop, diabetes and hypertension to have significant association with post-thyroidectomy hypocalcaemia. [23][24][25] Being a single center study with a relatively modest sample size are some of the limitations of this study. We only measured post-thyroidectomy serum calcium levels after 24-hours and as we known that most of the patients who develop hypocalcaemia are reported within first 24-hours while many of these cases return to normal calcium levels within few days so further following these patients about their serum calcium levels would have given us better insights.…”