title: Minimally invasive surgery using mini anterior incision for thyroid diseases: a prospective cohort study.
abstract: OBJECTIVE
  Minimally invasive surgical techniques have attracted interest in all surgical specialties since 1980. The thyroidectomy technique requires meticulous surgical dissection, absolute hemostasis, en bloc tumor resection and adequate visualization of the operative field, all of which can be accomplished with minimally invasive techniques.
  
  
  METHODS
  The study group comprised all patients undergoing MITS from its introduction in 2010 until July 2012. All data were prospectively recorded in the Elbistan Hospital and Suleyman Demirel University in Turkey. This study was designed to demonstrate our experience with mini-incision-technique in thyroidectomy.
  
  
  RESULTS
  Over the 2-year period, 37 patients underwent bilateral MITS procedures. The procedure made with a small (2.5 cm) anterior incision made above the isthmus. The final diagnoses were benign multinodular goitre (37%), follicular adenoma (28%) incidental carcinoma (11%), Hashimoto's thyroiditis (15%), Hurtle cell adenoma (5%), subacute thyroiditis (3%), residual thyroid-non carcinoma (2%), simple cyst (1%), diffuse hyperplasia (1%) and other (1%). Of the carcinomas, 80% were papillary thyroid cancer, 13% were follicular, and the remaining 7% were Hurtle cell carcinomas. We dont need to extend our incision in any cases. Two patients had temporary recurrent laryngeal nevre paresis and one patient had temporary hypocalcemia.
  
  
  CONCLUSIONS
  It is not easy to demonstrate the advantages of MIT over conventional and video-assisted surgery. The main complications, such as nerve injury, hypoparathyroidism, or hemorrhage, are the same as in other surgical approaches. MIT has demonstrated advantages over conventional open approaches for both hemi- and total thyroidectomy and the benefits do not depend on the open or video-assisted approach. The anterior mini-incision approach can be performed with an operative time and postoperative complication profile equivalent to conventional thyroidectomy while providing excellent cosmesis with a 2 cm scar in both total thyroidectomy and lobectomies.
authors.affiliation: Department of General Surgery, Faculty of Medicine, Suleyman Demirel University Isparta, Turkey.
authors.forename: Mehmet Zafer
authors.initials: MZ
authors.lastname: Sabuncuoglu
authors.affiliation: Isparta State Hospital Anesthesia and Critical Care Unit Isparta, Turkey.
authors.forename: Aylin
authors.initials: A
authors.lastname: Sabuncuoglu
authors.affiliation: Department of General Surgery, Ankara Numune Education and Research Hospital Ankara, Turkey;
authors.forename: Isa
authors.initials: I
authors.lastname: Sozen
authors.affiliation: Department of General Surgery, Faculty of Medicine, Suleyman Demirel University Isparta, Turkey.
authors.forename: Mehmet Fatih
authors.initials: MF
authors.lastname: Benzin
authors.affiliation: Department of General Surgery, Antalya Education and Research Hospital Antalya, Turkey.
authors.forename: Tugrul
authors.initials: T
authors.lastname: Cakir
authors.affiliation: Department of General Surgery, Izmir Bozyaka Education and Research Hospital Izmir, Turkey.
authors.forename: Recep
authors.initials: R
authors.lastname: Cetin
keywords: Minimal invasive thyroid surgery; anterior mini insicion; thyriodectomy; thyroid disease