What are the advantages of minimally invasive video-assisted thyroidectomy?

Updated: May 08, 2018
  • Author: Neerav Goyal, MD, MPH; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Answer

The current standard surgical technique was developed by Miccoli at the University of Pisa and brought to North America by Terris et al. [27, 28] The approach uses endoscopes and endoscopic instrumentation through a 15-20 mm incision. Current authors indicate a steep learning curve associated with the technique, as well as the need for a second assistant in the procedure; however, Miccoli did demonstrate a significant reduction in operative time after 30 cases.

Careful patient selection is required to ensure feasibility of this approach. Recent studies describe decreased postoperative pain, faster recovery, as well as improved cosmetic outcome as compared to conventional surgery, but with increased operative time. A meta-analysis of the currently published randomized controlled trials (total n=318, 5 trials) confirmed these differences (although it did not compare recovery time). [29] A recent cost-effective analysis in South Carolina described equal costs between the 2 approaches. [30]


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