Minimally Invasive Video-Assisted Thyroidectomy

Abstract

The minimally invasive video-assisted approach was first described in 1996 for parathyroid (Miccoli et al. 1997) and few years later for thyroid surgery (Bellantone et al. 1999; Miccoli et al. 1999). In the same period following the enthusiastic results of laparoscopic abdominal surgery, a purely endoscopic parathyroidectomy and thyroidectomy with multiple trocars placement and CO₂ insufflation were also performed (Gagner 1996; Huscher et al. 1997). The innovation of the video-assisted technique consisted of a gasless procedure performed through a single 1.5–2 cm central access and use of an endoscope for magnification. Because of its similarity to conventional surgery, this method gained quickly a quite large acceptance (Miccoli et al. 2002). Moreover, the attraction of the mini-incision has been supposed in earlier studies to be coupled with an advantage in terms of postoperative pain and cosmetic result in favour of MIVAT when compared to conventional thyroidectomy (Miccoli et al. 2001; Bellantone et al. 2002). Our experience with MIVAT is based on more than 1,500 procedures performed over more than 10 years experience in a tertiary referral centre for endocrine surgery.