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 ORIGINAL ARTICLE
Year : 2015  |  Volume : 11  |  Issue : 2  |  Page : 119-122

Minimally invasive video-assisted thyroidectomy: Ascending the learning curve


1 General Surgery 1 Unit, Emergency Department, Papa Giovanni XXIII Hospital, Bergamo, Italy
2 Thyroid and Parathyroid Surgery Unit, Surgeal Department, Sant' Andrea Hospital, La Sapienza University, Rome, Italy

Correspondence Address:
Michela Giulii Capponi
Papa Giovanni XXIII Hospital, Piazza OMS 1, Bergamo 24127
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-9941.153808

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Background: Minimally invasive video-assisted thyroidectomy (MIVAT) is a technically demanding procedure and requires a surgical team skilled in both endocrine and endoscopic surgery. The aim of this report is to point out some aspects of the learning curve of the video-assisted thyroid surgery, through the analysis of our preliminary series of procedures. Patients and Methods: Over a period of 8 months, we selected 36 patients for minimally invasive video-assisted surgery of the thyroid. The patients were considered eligible if they presented with a nodule not exceeding 35 mm and total thyroid volume <20 ml; presence of biochemical and ultrasound signs of thyroiditis and pre-operative diagnosis of cancer were exclusion criteria. We analysed surgical results, conversion rate, operating time, post-operative complications, hospital stay and cosmetic outcomes of the series. Results: We performed 36 total thyroidectomy and in one case we performed a consensual parathyroidectomy. The procedure was successfully carried out in 33 out of 36 cases (conversion rate 8.3%). The mean operating time was 109 min (range: 80-241 min) and reached a plateau after 29 MIVAT. Post-operative complications included three transient recurrent nerve palsies and two transient hypocalcemias; no definitive hypoparathyroidism was registered. The cosmetic result was considered excellent by most patients. Conclusions: Advances in skills and technology allow surgeons to easily reproduce the standard open total thyroidectomy with video-assistance. Although the learning curve represents a time-consuming step, training remains a crucial point in gaining a reasonable confidence with video-assisted surgical technique.






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