title: [Video-assisted surgery of the thyroid: outlines of the technique and analysis of the results].
abstract: BACKGROUND
  The authors described the technique of the video-assisted approach to thyroid surgery (MIVAT: minimally invasive video-assisted thyroidectomy), selection criteria of the patients and evaluated the technical feasibility of this method.
  
  
  METHODS
  Patients selection is based on many parameters. Exclusion criteria are: nodules greater than 35 mm, presence of thyroiditis, thyroid volume greater than 20 mL, previous neck surgery and irradiation. The surgical procedures are conducted through a minimal substernal skin incision (1-3 cm); the procedure performed using external retractors and needlescopic instruments.
  
  
  RESULTS
  MIVAT was accomplished in 20 patients (15 female and 5 men). One cervicotomy was required to perform total thyroidectomy (positive frozen section). Mean operative time was 70 min. Two patients have reported transient hypoparathyroidism; one patient has reported transient recurrent nerve palsy.
  
  
  CONCLUSIONS
  MIVAT has not yet met the favor of most endocrine surgeons; nevertheless we think that this technique is safe and feasible for benign thyroid diseases in selected cases, with the advantage of satisfactory cosmetic results Conversion to conventional surgery is required generally for local bleeding and to perform total thyroidectomy for positive frozen section.
  
  
  CONCLUSIONS
  MIVAT is feasible and may improve cosmetic outcome. The indications are limited at present, but the results are encouraging for the future.
authors.affiliation: Dipartimento Universitario di Scienze Chirurgiche, Ortopediche, Traumatologiche ed Emergenze (DUSCOTE) Cattedra di Chirurgia Generale e d'Urgenza Università degli Studi di Napoli Federico II.
authors.forename: M
authors.initials: M
authors.lastname: Musella
authors.forename: S
authors.initials: S
authors.lastname: Lombardi
authors.forename: P
authors.initials: P
authors.lastname: Caiazzo
authors.forename: F
authors.initials: F
authors.lastname: Milone
authors.forename: R
authors.initials: R
authors.lastname: Di Palma
authors.forename: S
authors.initials: S
authors.lastname: de Franciscis
authors.forename: R
authors.initials: R
authors.lastname: Jovino
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D020535:Video-Assisted Surgery / Q000379:methods*