title: Adopting the operating microscope in thyroid surgery: safety, efficiency, and ergonomics.
abstract: BACKGROUND
  Our aim was to assess the safety and efficiency of operating microscope use by surgeons in thyroid surgery to reduce static neck flexion.
  
  
  METHODS
  A retrospective case review comparing thyroidectomies performed using an operating microscope to those using surgical loupes was done. Operative times and incidence of complications were compared between total thyroidectomy procedures done with either microscope or loupes.
  
  
  RESULTS
  The use of microscope in 51 thyroidectomies (including 20 for malignancy with central compartment node dissection [CND] and 9 for substernal goiter [SG]) was compared with 65 cases (15 with CND and 11 with SG) done previously using loupes. Surgical times using the microscope were longer (p = .0001), but the increase was significant only in the subset of patients who underwent thyroidectomy with CND. There was no difference in complications between the groups.
  
  
  CONCLUSIONS
  The use of an operating microscope during thyroidectomy is safe with modest increases in surgical time.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Georgetown University Hospital, 3800 Reservoir Road NW, First floor, Gorman Building, Washington, District of Columbia 20007, USA. davidsob@gunet.georgetown.edu
authors.forename: Bruce J
authors.initials: BJ
authors.lastname: Davidson
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Guardiani
authors.forename: Andrea
authors.initials: A
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006042:Goiter / Q000601:surgery; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000295:instrumentation*; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000601:surgery; D013965:Thyroidectomy / Q000295:instrumentation*; D013997:Time Factors