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 videoassisted 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.