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Updated: May 20, 2026
Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
Published on: September 15, 2023
Minimally invasive video-assisted thyroidectomy: Learning curve in terms of mean operative time and conversion and
Yoann Pons1, Benjamin Vérillaud, Jean-Philippe Blancal
1Head and Neck Surgery Department, Hôpital Lariboisière, Paris, France. pons.yoann@gmail.com
Background:
The purpose of this study was to evaluate the learning curve for minimally invasive video-assisted thyroidectomy (MIVAT).
Methods:
Fifty consecutive patients were prospectively included in groups corresponding to their surgical order (10 patients in each group).
Results:
The mean operation times between 2 neighboring groups were 33.9 minutes longer in group 1 than in group 2 (p = .01) and 25.8 minutes longer in group 3 than in group 4 (p = .002). The conversion rate for technical difficulties in group 1 was 6% (3 of 50). The definitive complication rate was 2% (1 of 50).
Conclusions:
In terms of operative time, 10 patients represented the early stage of the learning curve, and 30 patients represented the number of procedures required to reach an advanced level of skill. Considering the low conversion and complication rates, improved aesthetic results and postoperative course, MIVAT should become a tool in the repertoire of high-volume thyroid surgeons.
Insights
This study assessed the learning curve for minimally invasive video-assisted thyroidectomy (MIVAT). Surgeons required approximately 30 procedures to achieve proficiency, demonstrating low complication rates for MIVAT.
Area of Science:
- Surgery
- Endoscopic Procedures
- Surgical Education
Background:
- Minimally invasive video-assisted thyroidectomy (MIVAT) is a specialized surgical technique.
- Evaluating the learning curve is crucial for surgeon training and patient safety.
Purpose of the Study:
- To assess the learning curve associated with performing MIVAT.
- To determine the number of procedures needed to achieve proficiency in MIVAT.
Main Methods:
- Fifty consecutive patients undergoing MIVAT were prospectively enrolled.
- Patients were divided into five groups of ten based on surgical order.
- Operative times and complication rates were analyzed across groups.
Main Results:
- Significant reductions in operative time were observed as surgeons progressed through the learning curve.
- The initial group (1-10 patients) showed longer operative times compared to subsequent groups.
- Low conversion rates (6%) and complication rates (2%) were reported, indicating safety.
Conclusions:
- Ten patients marked the early learning phase, while thirty procedures were needed for advanced skill acquisition in MIVAT.
- MIVAT offers potential benefits including improved aesthetics and postoperative recovery.
- MIVAT is recommended for high-volume thyroid surgeons due to its safety and efficacy.
