Minimally invasive video‐assisted total thyroidectomy: An easy to learn technique for skillful surgeons

Papavramidis, Theodossis S.; Michalopoulos, Nikolaos; Pliakos, John; Triantafillopoulou, Konstantina; Sapalidis, Konstantinos; Deligiannidis, Nikolaos; Κεσίσογλου, Ισαάκ; Ntokmetzioglou, Ioannis; Papavramidis, Spiros

doi:10.1002/hed.21336

Cited by 24 publications

(6 citation statements)

References 29 publications

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“…It is a procedure commonly performed across the country, in both large volume centres and small hospitals. MI techniques for thyroid surgery—not only MIVAT but many other approaches [12]—are proposed with increasing frequency but they require a high level of competence to minimise the length of the learning curve, which is otherwise rather long [13]. It has been stated that the "widespread application of this technique has been somewhat limited and, for practical purposes, has been confined to high-volume surgeons who have plentiful skilled assistants” [14].…”

Section: Discussionmentioning

confidence: 99%

Factors influencing the length of the incision and the operating time for total thyroidectomy

et al. 2012

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BackgroundThe incision used for thyroid surgery has become shorter over time, from the classical 10 cm long Kocher incision to the shortest 15 mm access achieved with Minimally Invasive Video-Assisted Thyroidectomy. This rather large interval encompasses many different possible technical choices, even if we just consider open surgery.The aim of the study was to assess the correlation between incision length and operation duration with a set of biometric and clinical factors and establish a rationale for the decision on the length of incision in open surgery.MethodsNinety-seven consecutive patients scheduled for total thyroidectomy were prospectively evaluated. All operations were performed by the same team and the surgeon decided the length of the incision according to his personal judgement. Patients who had previously undergone neck surgery were excluded.ResultsThe length of the incision was strongly correlated with gender, thyroid volume, neck circumference and clinical diagnosis and weakly correlated with the body mass index. Operation duration was only weakly correlated with gender and neck circumference. Multiple linear regression revealed that the set of factors assessed explained almost 60 % of the variance in incision length but only 20 % of the variance in operation duration. When patients were classified according to the distribution of their thyroid volume, cases within one standard deviation of the mean did not show a significant difference in terms of operation duration with incisions of various lengths.ConclusionsAlthough thyroid volume was a major factor in driving the decision with respect to the length of the incision, our study shows that it had only minor effect on the duration of the operation. Many more open thyroidectomies could therefore be safely performed with shorter incisions, especially in women. Duration of the operation is probably more closely linked to the inherent technical difficulty of each case.

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Section: Discussionmentioning

confidence: 99%

Factors influencing the length of the incision and the operating time for total thyroidectomy

et al. 2012

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“…It should be noted that the operative time for MIVAT in our previous cases decreased gradually with increased experience. It is well known that different types of operations need to be performed 15 to 100 times before reaching a low plateau of complications [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

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

Zheng¹,

Jie²,

Jiang³

2014

wiitm

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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.

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“…25 Papavramidis et al compared trainee operative time in minimally invasive video-assisted total thyroidectomy with that of a previously used technique, defining a learning curve of 8 cases. 42 A number of further studies have referenced trainee operative time to expert benchmarks in order to generate learning curves. 16,19,23,28,29,34,37,43 Merola et al used cumulative sum (CUSUM) analyses to determine a learning curve of 37 to 42 open inguinal hernia repairs for 4 general surgery trainees.…”

Section: Study Characteristics and Quality Assessmentmentioning

confidence: 99%

Defining operative experience targets in surgical training: A systematic review

Toale

O’Byrne

Morris

et al. 2022

Surgery

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Minimally invasive video‐assisted total thyroidectomy: An easy to learn technique for skillful surgeons

Abstract: Surgeons that are experience in both thyroid and endoscopic surgery are subjects to a short learning curve concerning MIVATT.

Cited by 24 publications

References 29 publications

Factors influencing the length of the incision and the operating time for total thyroidectomy

Factors influencing the length of the incision and the operating time for total thyroidectomy

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

Defining operative experience targets in surgical training: A systematic review

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