[The present place of video-assisted procedures in thyroid surgery]

Standardized surgical technique, the use of ultrasonic dissection and neuro- monitoring, have reduced morbidity in thyroid surgery, so that aesthetic aspects and endoscopic or minimally-invasive thyroid surgery have become more important for the patients.

We report on minimally-invasive and endoscopic procedures with either a cervical or extracervical access. Besides current literature we discuss our own results.

The critical evaluation of these procedures shows that the standards of endocrine surgery are not at all times entirely observed.

We therefore suggest requirements for endoscopic thyroid resection: The access trauma must be minimal, the aesthetic result must be optimal--without visible scars--and the size of the resected thyroid tissue should be the same as in open surgery. It has to be possible to resect the tissue en bloc. Only if the quality of the endoscopic thyroid resection is ensured aesthetic aspects may begin to play a role. If all these demands are fulfilled, the advantages of endoscopic resections do not only cover aesthetic aspects. The first results show less perioperative pain and a shorter stay in hospital. However, to prove this, further studies are necessary.