Video-assisted thyroidectomy for Graves? disease: report of a preliminary experience

Abstract

Graves' disease can be treated safely using VAT only if selection criteria are carefully respected. The young age of the patients with this disease encourages us to propose VAT for its good cosmetic and postoperative outcome.

Minimally invasive video-assisted thyreoidectomy (MIVAT) with and without use of harmonic scalpel—a randomized study

“…When HS was used in this study, the operating time was reduced by 33.9% as compared to the MIVAT lobectomy with the use of clips and bipolar coagulation, the intraoperative bleeding was reduced by 60.8%, the scar length was reduced by 27.5%, and the cosmetic satisfaction was improved at 1 month following surgery by 7.9% (significant difference for all the values). These outcomes are comparable to the values reported by others [7,25].…”

“…It is important to stress that a recent meta-analysis published by Miccoli showed that, in up to 86% of the eligible cases, the MIVAT operation is offered to patients with benign thyroid nodules, in 38.7% constituting a MIVAT lobectomy, and in 61.2% constituting a total thyroidectomy [6,25].…”

“…The instrument we used was approved for vessels up to 3 mm, which is sufficient for the MIVAT lobectomy-eligible patients. However, for patients with Grave's disease, the second generation of that instrument (ACE) would probably be more appropriate, as it was approved for closing vessels up to 5 mm in diameter [25]. It should be stressed that we have not used HS very close to the recurrent laryngeal nerves or the parathyroid glands, and we performed blunt dissection with the HS shears to reach a minimum distance of 5 mm to these structures, which is regarded to be twice as large as the reported safe one [17].…”

Minimally invasive video-assisted thyreoidectomy (MIVAT) with and without use of harmonic scalpel—a randomized study

“…When HS was used in this study, the operating time was reduced by 33.9% as compared to the MIVAT lobectomy with the use of clips and bipolar coagulation, the intraoperative bleeding was reduced by 60.8%, the scar length was reduced by 27.5%, and the cosmetic satisfaction was improved at 1 month following surgery by 7.9% (significant difference for all the values). These outcomes are comparable to the values reported by others [7,25].…”

“…It is important to stress that a recent meta-analysis published by Miccoli showed that, in up to 86% of the eligible cases, the MIVAT operation is offered to patients with benign thyroid nodules, in 38.7% constituting a MIVAT lobectomy, and in 61.2% constituting a total thyroidectomy [6,25].…”

“…The instrument we used was approved for vessels up to 3 mm, which is sufficient for the MIVAT lobectomy-eligible patients. However, for patients with Grave's disease, the second generation of that instrument (ACE) would probably be more appropriate, as it was approved for closing vessels up to 5 mm in diameter [25]. It should be stressed that we have not used HS very close to the recurrent laryngeal nerves or the parathyroid glands, and we performed blunt dissection with the HS shears to reach a minimum distance of 5 mm to these structures, which is regarded to be twice as large as the reported safe one [17].…”

Transoral endoscopic thyroidectomy vestibular approach (TOETVA) for Graves’ disease: a comparison of surgical results with open thyroidectomy

“…The results in the study remained the same, even with longer operative time. The rate of infection is also comparable to other endoscopic techniques (15)(16)(17)(18).…”

Minimally Invasive Video‐Assisted Thyroidectomy for Benign Thyroid Disease: An Evidence‐Based Review

“…Is MIVAT of any value in the treatment of benign thyroid diseases? To our knowledge, no article found in the PubMed database specifically addressed this topic, except for two articles that specifically dealt with the treatment of Graves’ disease [25, 26]. We then decided to analyze the larger and more recent series reported in the literature that report on the incidence of benign disease treated with the MIVAT technique and, in addition, analyze our most recent global series of patients.…”

Minimally invasive video-assisted thyreoidectomy (MIVAT) with and without use of harmonic scalpel—a randomized study

“…When HS was used in this study, the operating time was reduced by 33.9% as compared to the MIVAT lobectomy with the use of clips and bipolar coagulation, the intraoperative bleeding was reduced by 60.8%, the scar length was reduced by 27.5%, and the cosmetic satisfaction was improved at 1 month following surgery by 7.9% (significant difference for all the values). These outcomes are comparable to the values reported by others [7,25].…”

“…It is important to stress that a recent meta-analysis published by Miccoli showed that, in up to 86% of the eligible cases, the MIVAT operation is offered to patients with benign thyroid nodules, in 38.7% constituting a MIVAT lobectomy, and in 61.2% constituting a total thyroidectomy [6,25].…”

“…The instrument we used was approved for vessels up to 3 mm, which is sufficient for the MIVAT lobectomy-eligible patients. However, for patients with Grave's disease, the second generation of that instrument (ACE) would probably be more appropriate, as it was approved for closing vessels up to 5 mm in diameter [25]. It should be stressed that we have not used HS very close to the recurrent laryngeal nerves or the parathyroid glands, and we performed blunt dissection with the HS shears to reach a minimum distance of 5 mm to these structures, which is regarded to be twice as large as the reported safe one [17].…”

Transoral endoscopic thyroidectomy vestibular approach (TOETVA) for Graves’ disease: a comparison of surgical results with open thyroidectomy

“…The results in the study remained the same, even with longer operative time. The rate of infection is also comparable to other endoscopic techniques (15)(16)(17)(18).…”

Minimally Invasive Video‐Assisted Thyroidectomy for Benign Thyroid Disease: An Evidence‐Based Review

“…Is MIVAT of any value in the treatment of benign thyroid diseases? To our knowledge, no article found in the PubMed database specifically addressed this topic, except for two articles that specifically dealt with the treatment of Graves’ disease [25, 26]. We then decided to analyze the larger and more recent series reported in the literature that report on the incidence of benign disease treated with the MIVAT technique and, in addition, analyze our most recent global series of patients.…”

Minimally invasive video-assisted thyreoidectomy (MIVAT) with and without use of harmonic scalpel—a randomized study

“…When HS was used in this study, the operating time was reduced by 33.9% as compared to the MIVAT lobectomy with the use of clips and bipolar coagulation, the intraoperative bleeding was reduced by 60.8%, the scar length was reduced by 27.5%, and the cosmetic satisfaction was improved at 1 month following surgery by 7.9% (significant difference for all the values). These outcomes are comparable to the values reported by others [7,25].…”

“…It is important to stress that a recent meta-analysis published by Miccoli showed that, in up to 86% of the eligible cases, the MIVAT operation is offered to patients with benign thyroid nodules, in 38.7% constituting a MIVAT lobectomy, and in 61.2% constituting a total thyroidectomy [6,25].…”

“…The instrument we used was approved for vessels up to 3 mm, which is sufficient for the MIVAT lobectomy-eligible patients. However, for patients with Grave's disease, the second generation of that instrument (ACE) would probably be more appropriate, as it was approved for closing vessels up to 5 mm in diameter [25]. It should be stressed that we have not used HS very close to the recurrent laryngeal nerves or the parathyroid glands, and we performed blunt dissection with the HS shears to reach a minimum distance of 5 mm to these structures, which is regarded to be twice as large as the reported safe one [17].…”

Transoral endoscopic thyroidectomy vestibular approach (TOETVA) for Graves’ disease: a comparison of surgical results with open thyroidectomy

“…The results in the study remained the same, even with longer operative time. The rate of infection is also comparable to other endoscopic techniques (15)(16)(17)(18).…”

Minimally Invasive Video‐Assisted Thyroidectomy for Benign Thyroid Disease: An Evidence‐Based Review

“…Is MIVAT of any value in the treatment of benign thyroid diseases? To our knowledge, no article found in the PubMed database specifically addressed this topic, except for two articles that specifically dealt with the treatment of Graves’ disease [25, 26]. We then decided to analyze the larger and more recent series reported in the literature that report on the incidence of benign disease treated with the MIVAT technique and, in addition, analyze our most recent global series of patients.…”