[Alternative approaches in thyroid surgery].

Area of Science:

• Surgery
• Endocrinology
• Surgical Oncology

Background:

• Over the past 20 years, various minimally invasive and endoscopic techniques have emerged for thyroid surgery.
• The primary goal of these alternative thyroidectomy approaches is to enhance cosmetic outcomes.
• Indications for alternative and conventional thyroid surgery are similar, but specific patient and disease factors are crucial.

Purpose of the Study:

• To provide an overview of clinically implemented alternative thyroid surgery approaches.
• To critically evaluate the safety and applicability of these novel techniques.

Main Methods:

• Review of current literature on alternative thyroid surgery techniques.
• Categorization of approaches into cervical minimally invasive, extracervical endoscopic (robot-assisted), and transoral (NOTES).

Main Results:

• Most alternative thyroid surgery methods are still considered experimental.
• Contraindications include large goiters, advanced cancers, reoperations, and prior neck radiation.
• Only a few approaches, like minimally invasive video-assisted thyroidectomy (MIVAT) and robotic-assisted thyroidectomy (RAT), are safe in select cases.

Conclusions:

• Alternative thyroid surgery techniques demand significant surgeon experience and meticulous patient selection.
• Patient safety must remain paramount, outweighing the desire for improved cosmetic results.
• Widespread adoption of alternative thyroid surgery is limited due to ongoing safety and efficacy evaluations.