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MIVAT: the last 2 years experience, tips and techniques after more than 10 years

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Abstract

Background

Minimally invasive video-assisted thyroidectomy (MIVAT) has been introduced into clinical practice by Miccoli in the late 1990s (Miccoli et al., Am J Surg 181(6):567–570, 2001) and it has become a widespread technique used and welcomed worldwide. In this paper, we present our experience of the last 2 years; we also describe tips and techniques derived from over 460 cases performed in the last 10 years by the same surgical team with the same single operator.

Methods

In the last 10 years, we did about 460 MIVAT procedures. In the last 2 years, we performed MIVAT on 156 consecutive patients at Sant’Andrea University Hospital of Rome “Sapienza” University. of 156 cases performed, we were able to monitor the follow-up in 110 patients.

Results

On 110 cases, the mean surgical time was 74 ± 7.2 min. In our data, we reported: transitory hypoparathyroidism 11 (10%), definitive hypoparathyroidism 4 (3.60%) (this value is inclusive of patients treated with central neck dissection. The value referred only to MIVAT is 1.05%), 2 (1.81%) transitory monolateral nerve palsy, 16 (14.50%) transitory, and 1 (0.9%) definitive nerve palsy. 4 (3.60%) cases of transitory dysphagia and 0 (0%) cases of definitive dysphagia (Table 4). We also had 1 (0.9%) case of surgical scar infection, 0 (0%) postoperative bleeding, and 2 (1.81%) cases of subcutaneous surgical adhesion. Cosmetic results were: 0 (0%) insufficient, 0 (0%) sufficient, 6 (6.30%) passable, 17 (15.50%) good. and 86 (78.20%) excellent. Conversion rate 0 (0%).

Conclusion

MIVAT is a good and safe technique, with similar short-term outcomes and similar costs compared to traditional total thyroidectomy. We hope that the tips and techniques reported in this paper as well as the advices in the use of instruments in MIVAT and open surgery will be useful to improve the skills of young surgeons and make thyroid surgery less invasive.

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Authors and Affiliations

  1. Division of Thyroid and Parathyroid Surgery, Department of Surgery, Sant’Andrea Hospital, II Faculty of Medicine and Surgery, Sapienza University, Rome, Italy

    C. Bellotti, M. Cinquepalmi, G. Castagnola & S. Marchetta

  2. Division of Week and Day Surgery, Department of Surgery, Sant’Andrea Hospital, II Faculty of Medicine and Surgery, Sapienza University, Rome, Italy

    C. Bellotti, M. Cinquepalmi, G. Castagnola, S. Marchetta, F. Mallozzi, M. Pezzatini & A. Brescia

  3. Department of General Surgery 1, Papa Giovanni XXIII Hospital, Bergamo, Italy

    M. Giulii Capponi

Authors
  1. C. Bellotti
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  3. M. Cinquepalmi
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  4. G. Castagnola
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  8. A. Brescia
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Contributions

CB: first operator in all surgery. MGC, MC, GC, SM, FM, MP, and AB contributed data collection.

Corresponding author

Correspondence to M. Cinquepalmi.

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Disclosures

C. Bellotti , M. Giulii Capponi, M. Cinquepalmi, G. Castagnola, S. Marchetta, F. Mallozzi, M. Pezzatini, A. Brescia have no conflicts of interest or financial ties to disclose.

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Bellotti, C., Capponi, M.G., Cinquepalmi, M. et al. MIVAT: the last 2 years experience, tips and techniques after more than 10 years. Surg Endosc 32, 2340–2344 (2018). https://doi.org/10.1007/s00464-017-5929-7

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  • DOI: https://doi.org/10.1007/s00464-017-5929-7

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