Minimally invasive video-assisted thyroidectomy: a multi-institutional North American experience.

OBJECTIVE

To report the results of a multi-institutional experience with the minimally invasive video-assisted thyroidectomy, which was conceived in Europe and Asia and has only recently been embraced in the United States.

DESIGN

Prospective, nonrandomized analysis.

SETTING

Four academic thyroid surgical practices.

PATIENTS: Consecutive series of 228 patients who required thyroid surgery and were deemed at surgeon discretion to be eligible for a minimal access surgery.

INTERVENTIONS: Minimally invasive video-assisted thyroidectomy was performed in 216 patients.

MAIN OUTCOME MEASURES: The data, which were recorded prospectively, included age, sex, indication for surgery, incision length, and complications of surgery.

RESULTS

Because conversion to an open approach was required in 12 of the 228 patients, the study group comprised 216 patients (25 men and 191 women; mean [SD] age, 44.5 [14.1] years). There were no hematomas and no cases of permanent hypoparathyroidism or permanent vocal cord paralysis. Nine patients had a transient vocal cord paresis (3.2% of nerves at risk); 5 patients experienced temporary hypocalcemia (8.1% of total thyroidectomies); 1 patient reported a change in voice pitch; and 1 patient required a scar revision.

CONCLUSIONS

Use of the minimally invasive video-assisted thyroidectomy technique has been adopted cautiously in the United States. The safety of the procedure represented by the data from this multi-institutional experience would support its expanded adoption by high-volume thyroid surgeons.