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

ABSTRACT

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.