Minimally invasive video-assisted thyroidectomy: reflections after more than 2400 cases performed

Miccoli, Paolo; Biricotti, Marco; Matteucci, Valeria; Ambrosini, Carlo Enrico; Wu, Jungle Chi-Hsiang; Materazzi, Gabriele

doi:10.1007/s00464-015-4503-4

Cited by 45 publications

(42 citation statements)

References 37 publications

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“…This is even more evident in areas of the world where iodine deficiency is endemic and a large thyroid volume is a major limitation. In the authors' experience only 15% of patients were candidates for the procedure (26). Lower figures (10% or less) have been reported from regions where goitre is endemic (37).…”

Section: Mivat's Disadvantagesmentioning

confidence: 75%

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 Disadvantagesmentioning

confidence: 75%

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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“…Возникают вопросы о целесообразности выполнения оперативных вмешательств из отдалённых доступов (изолированного трансаксиллярного, позадиушного), при которых хирургическая травма тканей и риск развития осложнений существенно выше. В связи с этим в нашей работе применены наиболее целесообразные с клинических позиций методики [10,14,17,20,23].…”

Section: информативность инструментальных методов диагностики в выявлunclassified

“…Оценены возможности технического выполнения оперативных вмешательств с использованием основных методик, которые позволили разделить больных на четыре группы: 1-ю (n = 133) составили пациенты, прооперированные традиционным способом; 2-ю (n = 30) -с использованием видеоассистированного минимально-инвазивного доступа (minimally invasive videoassisted thyroidectomy, MIVAT) на передней поверхности шеи; 3-ю (n = 61) -с применением трансаксиллярного трансареолярного эндовидеохирургического доступа (axillo-bilateral-breast approach -АВВА); 4-ю (n = 98) -минимально-инвазивного неэндоскопического (minimally invasive nonendoscopic thyroidectomy, MIT). Критерии отбора пациентов для оперативных вмешательств соответствовали опубликованным и учитывали основные факторы: размер узловых образований, объём ЩЖ, наличие экстратиреоидного распространения при высокодифференцированном раке ЩЖ и поражение регионарных лимфатических узлов [7,11,14,20].…”

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Substantiation of minimally invasive surgeries on thyroid gland

Майстренко

Romashchenko

Криволапов

2017

VESTNIK KHIRURGII IMENI I.I.GREKOVA

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Кафедра и клиника факультетской хирургии им. С. П. Фёдорова (зав. -акад. РАН проф. Н. А. Майстренко), ФГБВОУ ВО «Военно-медицинская академия им. С. М. Кирова» МО РФ, Санкт-Петербург ЦЕЛЬ ИССЛЕДОВАНИЯ. Определить критерии отбора больных хирургическими заболеваниями щитовидной железы (ЩЖ) для обоснованного выполнения оптимальных минимально-инвазивных оперативных вмешательств. МАТЕРИАЛ И МЕТОДЫ. Проанализированы результаты лечения 322 пациентов с хирургическими заболеваниями ЩЖ, которые были прооперированы с применением традиционного и различных малоинвазивных доступов. РЕЗУЛЬТАТЫ. Установлено, что основными критериями, обусловливающими выбор рационального минимально-инвазивного вмешательства, являются: размер узловых образований и объём ЩЖ; аутоиммунное воспаление тиреоидной ткани на фоне узлового токсического и диффузного токсического зоба; загрудинное расположение зоба; необходимость выполнения центральной лимфодиссекции при метастатическом поражении лимфатических узлов. ЗАКЛЮЧЕНИЕ. Применение установленных критериев на основе комплексного использования современных диагностических методик у больных с хирургическими заболеваниями ЩЖ позволяет обосновать выбор оптимальных минимально-инвазивных оперативных вмешательств, избежать неоправданных операций и улучшить результаты лечения. Substantiation of minimally invasive surgeries on thyroid glandDepartment and clinic of faculty surgery named after S. P. Fyodorov, S. M. Kirov Military Medical Academy, St. Petersburg OBJECTIVE. The authors determined criteria for reasonable selection of patients for application of optimal minimally invasive interventions in cases of thyroid gland diseases. MATERIAL AND METHODS. The treatment results of 322 patients with thyroid gland diseases were analyzed. There were used a conventional method and variety of minimally invasive methods. RESULTS. It was stated that the main criteria that verified a choice of optimal minimally invasive surgery were the nodule size and thyroid gland volume, autoimmune inflammation of thyroid tissues against a background of toxic and diffuse toxic goiter, retrosternal goiter position and necessity of central lymphodissection in case of metastatic thyroid gland. CONCLUSIONS. The authors applied the determined criteria based on modern diagnostic methods in patients with surgical thyroid gland diseases. This study allowed doctors to justify the choice of optimal minimally invasive surgeries and avoid unreasonable operations, improve treatment results.

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“…Minimally invasive procedures primarily focus on the size of the incision, with most agreeing that remote access is not the same as minimally invasive . Remote access thyroidectomy involves moving the incision from the visible portion of the neck and placing it in a more discrete location .…”

Section: Introductionmentioning

confidence: 99%

“…6 Minimally invasive procedures primarily focus on the size of the incision, with most agreeing that remote access is not the same as minimally invasive. [7][8][9][10][11][12] Remote access thyroidectomy involves moving the incision from the visible portion of the neck and placing it in a more discrete location. [13][14][15] Of multiple remote access approaches that have been employed at our institution and elsewhere, the transoral endoscopic vestibular approach thyroidectomy (TOETVA) has become preferred due to the short learning curve and broad indications.…”

Section: Introductionmentioning

confidence: 99%

Objectively measuring social attention of thyroid neck scars and transoral surgery using eye tracking

Juárez¹,

Ishii

Nellis

et al. 2019

The Laryngoscope

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Objective Measure the social attention of thyroid neck scars and transoral surgery using eye tracking. Methods Observers viewed images of patients with thyroid neck scars, control patients with no scars, and patients who underwent transoral thyroidectomy as an eye‐tracking monitor recorded their eye movements. Hotelling's multivariate analysis, followed by planned posthypothesis testing, were used to compare fixation times for the central triangle (CT), peripheral face, and neck between the three groups. To assess if these gaze patterns would normalize with transoral surgery, a two‐sample t test was done to assess for differences in neck fixations between control and transoral patients and between transoral and traditional thyroidectomy. Results One hundred and thirty participants completed the eye‐tracking experiment (mean age 24.3 years, 65 females). Observers directed the majority of their attention to the CT in both control and scar patients. Observers paid more attention to the neck (103.72 ms, P < .0001, 95% confidence interval [CI] [55, 152] ms) and less to the peripheral face (115.50 ms, P = .01, 95% CI [19, 211] ms) in patients with neck scars than in control patients. Furthermore, transoral surgery eliminated this attentional distraction wherein there was no difference in the fixation time to the neck (−39.198 ms P = .16, 95% CI [−93.978, 15.5816] ms) between controls and those who underwent transoral surgery. Conclusion Observers directed their gaze away from the face and toward the neck in patients with thyroid neck scars. Furthermore, this distraction was eliminated with tranoral surgery. These findings shed light onto the altered observer perceptions of patients with thyroid neck scars. Level of Evidence NA Laryngoscope, 129:2789–2794, 2019

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Minimally invasive video-assisted thyroidectomy: reflections after more than 2400 cases performed

Cited by 45 publications

References 37 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

Substantiation of minimally invasive surgeries on thyroid gland

Objectively measuring social attention of thyroid neck scars and transoral surgery using eye tracking

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