Minimally invasive video-assisted thyroidectomy.
BACKGROUND
Minimally invasive video-assisted thyroidectomy (MIVAT) has been developed and successfully used in Italy to perform thyroidectomy and central node dissection through an incision of 2 to 3 cm.


OBJECTIVE
Determine the safety, utility, and complication rates of MIVAT in a university setting within the United States.


METHODS
Single surgeon series of MIVAT performed during an 18-month period.


RESULTS
Two hundred fifty thyroidectomies were performed between January 2006 and June 2007. Ninety-two (37%) met eligibility criteria for MIVAT. Six (7%) procedures were converted to open thyroidectomy (incision 4-5 cm) because of extent of the disease (3 strap muscle invasions, 1 thyroiditis, and 2 excessive size goiters). Eighty-six (93%) procedures were completed via the MIVAT technique. There was one case of transient and no cases of permanent recurrent laryngeal nerve paralysis (0.7% of nerves at risk). There were two cases of transient hypocalcemia (3.6% of total/completion cases). There were no hematomas or seromas. There were five (5.8%) cases of minor superficial skin burn. Mean operative times were significantly reduced during the study period (67 to 42 min for hemithyroidectomy, P = .0005; 110 to 77 min for total thyroidectomy, P = .02). Mean incision length measured after wound closure was 2.5 cm.


CONCLUSIONS
We found implantation of MIVAT to be safe, with rates of hypocalcemia, vocal cord paresis, and hematoma comparable with those reported for the traditional open approach. Procedure times varied based on extent of thyroidectomy, patient factors, and experience of the operator and were significantly reduced during the study period.
Vaysberg
Mikhail
M
Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA.
Steward
David L
DL
D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006042:Goiter / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation*; D011446:Prospective Studies; D012307:Risk Factors; D013965:Thyroidectomy / Q000295:instrumentation*; D013966:Thyroiditis / Q000601:surgery*; D020535:Video-Assisted Surgery / Q000295:instrumentation*