Minimally Invasive Techniques for Thyroidectomy

A study examining newer approaches to remove diseased thyroids highlights two safe, effective treatment options that can dramatically reduce the size of neck incisions and also speed recovery.

The study looked at 31 patients who underwent minimally invasive thyroidectomy (removal of the thyroid gland) in which surgeons cut through the muscle to gain direct access to the gland, working through an incision about half the size of the norm, and 14 patients who underwent an endoscopic approach, in which an endoscope was paired with a harmonic ultrasonic scalpel--which coagulates as it cuts--enabling the smallest incisions yet for this approach. The endoscopic approach was fine-tuned by Dr. Paolo Miccoli of the University of Pisa (Italy). The study was published in the March 2006 issue of the journal Laryngoscope, and the online edition also features an accompanying surgery video for the first time.

In addition to an improved cosmetic result, minimally invasive approaches reduce surgical trauma and recovery time, with most patients going home within a few hours of surgery. While most patients with the option prefer a less-invasive approach, the standard approach, which results in a three-to-four-inch incision at the base of the neck, will still be needed by some. This includes patients whose gland has grown too large to be removed through a small opening. About 30% of patients need this approach using a larger incision and moving aside underlying muscle to remove the thyroid.

"Both work well; both have a place in a usual practice,” said lead author Dr. David J. Terris, chair of the department of otolaryngology, head and neck surgery, at the Medical College of Georgia (Augusta, GA, USA). "The harmonic scalpel allows us to safely secure blood vessels in small spaces without needing to tie the vessels. You reach up and ligate vessels through endoscope guidance.”



Related Links:
University of Pisa
Medical College of Georgia