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OTORINOLARINGOLOGIA

A Journal on Otorhinolaryngology, Head and Neck Surgery,
Plastic Reconstructive Surgery, Otoneurosurgery


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Otorinolaringologia 2009 June;59(2):89-95

language: English

Minimally invasive and endoscopic thyroid surgery

Benhidjeb T. 1, Rückert J.-C. 1, Burghardt J. 2, Müller J. M. 1

1 Department of General, Visceral Vascular and Thoracic Surgery Charité - Universitätsmedizin Berlin Campus Mitte, Berlin, Germany
2 Department of Surgery Rüdersdorf Hospital, Rüdersdorf, Germany


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Neck surgery is one of the latest applications of minimally invasive surgery. Various thyroidectomy approaches via the neck, axilla, chest wall, and breast have been reported. These new techniques are compared with the fact that they have to compete with conventional thyroidectomy, with its high standard of treatment in terms of both efficacy and of safety. Aim of this paper was to report the results of published methods of minimally invasive and endoscopic thyroid surgery. PubMed database was searched and analysis of the appropriate literature was performed. Among the cervical approaches the minimally invasive video-assisted thyroidectomy technique is the method that has so far become most widespread and is considered the most easily consistent procedure of its class of operations. Limiting factors of all cervical approaches include the length of the incision and consequently the size of the specimen resected. Furthermore, rather than the length of the neck incision, the quality of the scar, including its potential drawbacks, is a determinant for the cosmetic result. Despite the relatively limited number of patients involved, feasibility and safety of the extracervical approaches could be demonstrated in all published reports. A distinct advantage is the absence of a wound on the anterior neck. In addition, the technique is not limited to nodules up to a maximum size of 30 mm. However, the extracervical approach is not a minimally invasive technique but a maximally invasive one, that involves longer operative time, greater postoperative pain and a steep learning curve. Currently, it is not possible to make an evidence-based recommendation since superiority of endoscopic to conventional thyroidectomy has not yet been demonstrated. However, there exists general agreement that cervical and extracervical thyroidectomy is a valid and feasible option for carefully selected patients.

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