Incorporating Microdebrider Use in a Community-Based Thyroidectomy Practice

Area of Science:

• Otolaryngology
• Head and Neck Surgery
• Surgical Technology

Background:

• Substernal goiters pose surgical challenges due to their location.
• Transcervical removal is common, but extensive goiters may necessitate sternotomy.
• Microdebrider use for substernal goiter removal is not widely adopted despite its use in other surgeries.

Purpose of the Study:

• To report the experience of using a microdebrider (soft tissue shaver) to facilitate transcervical removal of substernal goiters.
• To evaluate the safety and efficacy of this technique in a community thyroidectomy practice.

Main Methods:

• Retrospective review of thyroidectomy cases from January 2017 to December 2019.
• Analysis of four cases where microdebrider was used for intracapsular debulking of substernal goiters.
• Evaluation of pre- and perioperative factors, surgical technique, estimated blood loss, surgical time, complications, and length of stay.

Main Results:

• No sternotomy was required in the four cases.
• Average estimated blood loss was 237.5 ml, and average surgical time was 137 minutes.
• One patient experienced a postoperative hematoma; all others had uncomplicated recoveries and overnight stays.

Conclusions:

• The microdebrider is a safe and effective tool for general otolaryngologists to facilitate transcervical substernal goiter removal.
• Adoption of this technique can decrease the need for sternotomy, reduce morbidity, shorten hospital stays, and lower costs.