An easier technique for minimally invasive video-assisted thyroidectomy

Area of Science:

• Surgery
• Endocrine Surgery
• Minimally Invasive Surgery

Background:

• Minimally invasive video-assisted thyroidectomy (MIVAT) offers cosmetic and analgesic benefits but has limitations.
• The original MIVAT technique faced challenges including extended operating times and a steep learning curve.
• These factors hindered widespread adoption of MIVAT.

Purpose of the Study:

• To report a modified MIVAT procedure designed to simplify the technique and shorten the learning period.
• To compare the outcomes of the modified MIVAT with the originally described MIVAT method.
• To evaluate the feasibility and effectiveness of the modified approach in eligible patients.

Main Methods:

• A modified MIVAT procedure was developed using a self-designed Army retractor with a mosaic ring.
• Sixty patients meeting specific criteria (unilateral nodules <50mm, benign, no prior neck issues) underwent lobectomy via MIVAT.
• Patients were divided into two groups: original MIVAT (Group A, n=17) and modified MIVAT (Group B, n=43).

Main Results:

• The modified MIVAT (Group B) significantly reduced mean operative time to 59.2 minutes from 120 minutes (Group A).
• No significant difference in incision size was observed between the groups.
• Group B had no conversions to open surgery and no postoperative complications, unlike Group A which had one transient recurrent laryngeal nerve palsy and one conversion.

Conclusions:

• The modified MIVAT procedure using the Army retractor with a mosaic ring simplifies the operation.
• This modification effectively reduces operative time and the learning curve associated with MIVAT.
• The modified technique provides similar advantages to the original MIVAT while enhancing ease of use and safety.