Istvan Gal, MD PhD, Miklos Czobel, MD, Zoltan Szabo, PhD, Gyorgy Weber, MD PhD. Telki Private Hospital, Budapest-Telki, Hungary, Department of Surgery University Medical School of Szeged, Hungary, M.O.E.T. Institute San Francisco, CA, USA, Department of Surgical Research and Technique University Medical School of Pécs,Hungary
Minimally invasive video-assisted thyroidectomy(MIVAT)was described in 1988.The technique was adopted and the initial experiences were published by the authors in 2006.In this study we collect the data of our last one hundred cases.Selection criteria for MIVAT were echographically determined thyroid volume less or equal 25 ml, nodules not exceeding 35mm of diameter,and an absence of thyroiditis, previous neck surgery, or previous irradiation.The procedure, which is totally gasless,is carried out through a 2-2.5 cm central incision above the sternal notch.Dissection is performed under endoscopic vision using conventional and endoscopic instruments.The mean age of our patients was 40.5 years (26-54 years), including 11 men and 89 female patients. The indication for operations was follicular or suspicious lesion 61, benigne nodul(s)25,hyperthyroidism with diffuse disease 14.The mean operative time was 59.5 min for lobectomy(range 35-85min) and 77.8 min for total or almost total thyroidectomy (range 45-140min).No conversion was necessary to open surgery.The mean postoperative stay was 1.6 days(1-3 days).Postoperative complications included 3 transient recurrent laryngeal nerve palsies and 8 transient hypoparathyroidism.Neither definitive recurrent laryngeal nerve palsy nor definitive hypothyroidism was observed. Postoperative hematoma required exploration in one case.Authors conclude:although indication for MIVAT are still limited (15-20% of patients who required thyroidectomy), it should be considered as real alternative in thyroid surgery, offering some advantages for patients in terms of cosmetic results and postoperative distress.
Program Number: P503