[Minimally invasive video-assisted thyroidectomy: establishment in a thyroid center]

Area of Science:

• Endocrinology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Retrospective evaluation of minimally invasive video-assisted thyroidectomy (MIVAT) during its introduction phase.
• Study conducted at Martha-Maria Hospital, Nuremberg.

Purpose of the Study:

• To assess the safety and feasibility of MIVAT.
• To compare patient satisfaction and cosmetic outcomes between MIVAT and conventional thyroid surgery.

Main Methods:

• Retrospective analysis of patients who underwent MIVAT (n=55) and conventional thyroid surgery (n=45) between August 2008 and July 2009.
• Eligibility criteria for MIVAT included thyroid volume < 25 ml, nodules < 30 mm, no thyroiditis, no preoperative carcinoma, and no prior neck surgery.
• Follow-up included assessment of general patient satisfaction and cosmetic results.

Main Results:

• No significant differences in perioperative complication rates (e.g., nerve palsy, hypocalcemia, hemorrhage) between MIVAT and conventional surgery.
• MIVAT group showed significantly longer mean operating time initially, but a decrease was observed after 5 months, indicating a learning effect.
• Patients in the MIVAT group reported significantly higher satisfaction with cosmetic outcomes and the overall surgical procedure.

Conclusions:

• MIVAT demonstrates a learning curve effect, with reduced operating time and conversion rates over time.
• MIVAT is a safe and feasible surgical option when appropriate eligibility criteria are met.
• MIVAT offers improved cosmetic results and patient satisfaction compared to conventional thyroidectomy.