[Significance of the limiting lamella in struma surgery]

When thyroid surgery was founded and developed by BILLROTH, KOCHER, MICULICZ, HALSTED and de QUERVAIN a variable approach was practised with respect to the extent of dorsal mobilization, completeness of goiter resection and fineness of the operative technique. These aspects of goiter resection are actually still of interest: Nodules are now considered as growth marker and they must be completely excised, necessitating a careful dorsal mobilization; Kocher's correct plane of dissection is now anatomically defined as laying anterior to the lamella which covers the vessel and nerve-containing plate of the neck. This technical approach for complete goiter excision revealed to harbour a low operative morbidity, to eliminate autonomous function, and to prevent goiter recurrence.