Video-assisted surgery of the thyroid diseases.

Background: After first endo- scopic parathyroidectomy, performed and de- scribed by Gagner in 1996, several surgeons re- ported their experiences with minimally invasive and video-assisted (MIVA) surgery of the neck. The patients were considered eligible for MI- VA hemithyroidectomy and thyroidectomy on the basis of some criteria. Methods: Completely gasless procedure, is carried out through a 15-30 mm central incision above the sternal notch. Dissection is per- formed mainly under endoscopic vision using conventional endoscopic instruments. Video assisted group in our experience included 5 pa- tients. All patients were women with mean age of 56 years. Results: We performed in three cases a total thyroidectomy and in two an hemithyroidecto- my. Operative mean time was 189 minutes. No complications are happened. No conversion have been necessary. Discussion: Traditionally, open thyroidecto- my require a 6 to 8 cm, or bigger, transverse wound on the lower neck. The minimally inva- sive approach wound is very small in length (1.5 cm for small nodules, maximum 2-3 cm for the biggest, in respect of the exclusion criteria) upon the suprasternal notch. Wound pain following the MIVA surgery is much less when compared with the conven- tional thyroidectomy, because there is less dis- section and destruction of tissues. The treated pathologies are prevalently nodular goiter; the only kind of thyroid cancer what it may be attacked with endoscopic surgery is a small papillary carcinoma without lymph node involvement. The complications, there are the same com- plications of the traditional thyroidectomy.