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Updated: Dec 28, 2025
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Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
Published on: May 12, 2023
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Minimally invasive video-assisted thyroidectomy (MIVAT).
Paolo Miccoli1, Lorenzo Fregoli1, Leonardo Rossi1
1Department of Endocrine Surgery, University of Pisa, Pisa, Italy.
Gland Surgery
|February 15, 2020
Summary
Minimally invasive video-assisted thyroidectomy (MIVAT) is a safe and effective procedure for various thyroid conditions. This technique offers better cosmetic outcomes and reduced pain compared to traditional surgery.
Area of Science:
- Endocrine Surgery
- Minimally Invasive Surgery
Background:
- Minimally invasive video-assisted thyroidectomy (MIVAT) has evolved since its 1999 introduction.
- Initially for benign nodules, MIVAT is now used for diverse thyroid diseases within selection criteria.
- MIVAT shows comparable oncologic outcomes, cost, and complication rates to standard open thyroidectomy (SOT).
Purpose of the Study:
- To evaluate the safety and efficacy of MIVAT over a 20-year period.
- To assess complication rates and cosmetic benefits of MIVAT.
- To compare MIVAT with standard open thyroidectomy (SOT).
Main Methods:
- Retrospective analysis of patients undergoing MIVAT from 1998 to 2019.
- Strict adherence to established indications and contraindications for MIVAT.
- Data collection on procedure types, conversions, and postoperative outcomes.
Main Results:
- MIVAT performed in 2,625 cases: 1,862 total thyroidectomies and 763 hemithyroidectomies.
- Low conversion rate of 1.6% (43 cases).
- Low rates of transient (7%) and definitive (0.4%) hypoparathyroidism; low rate of definitive recurrent laryngeal nerve palsy (1.4%).
Conclusions:
- MIVAT is a safe surgical procedure with a low complication rate.
- MIVAT offers significant advantages in cosmetic results and reduced postoperative pain.
- The 20-year experience reaffirms MIVAT's value without increased costs or complications.
