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      Minimally Invasive Video-Assisted versus Minimally Invasive Nonendoscopic Thyroidectomy

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          Abstract

          Minimally invasive video-assisted thyroidectomy (MIVAT) and minimally invasive nonendoscopic thyroidectomy (MINET) represent well accepted and reproducible techniques developed with the main goal to improve cosmetic outcome, accelerate healing, and increase patient's comfort following thyroid surgery. Between 2007 and 2011, a prospective nonrandomized study of patients undergoing minimally invasive thyroid surgery was performed to compare advantages and disadvantages of the two different techniques. There were no significant differences in the length of incision to perform surgical procedures. Mean duration of hemithyroidectomy was comparable in both groups, but it was more time consuming to perform total thyroidectomy by MIVAT. There were more patients undergoing MIVAT procedures without active drainage in the postoperative course and we also could see a trend for less pain in the same group. This was paralleled by statistically significant decreased administration of both opiates and nonopiate analgesics. We encountered two cases of recurrent laryngeal nerve palsies in the MIVAT group only. MIVAT and MINET represent safe and feasible alternative to conventional thyroid surgery in selected cases and this prospective study has shown minimal differences between these two techniques.

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          Most cited references52

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          Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism.

          M Gagner (1996)
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            Endoscopic thyroidectomy by the axillary approach.

            Neck surgery has recently become one of the newest fields for the application of endoscopic surgery because the resultant scar is small and inconspicuous. Still, some patients feel even a small scar on the neck is not cosmetically acceptable. We therefore have developed a new technique of endoscopic thyroidectomy by the axillary approach that leaves no scar on the neck at all. When this method is used, the small scar in the axilla is completely covered by the patient's arm in a natural manner. The cosmetic result is excellent, and sensory loss in the neck is negligible because the area of surgical dissection is small. We believe that endoscopic thyroid surgery by the axillary approach will find a role in the treatment of thyroid disease.
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              Minimally invasive surgery for thyroid small nodules: preliminary report.

              Cytological assessment of cold thyroid nodules cannot exclude malignancy in case of follicular tumors. Many follicular nodules undergo surgery although most of them later on prove to be benign. We report a new minimally invasive video-assisted approach (MIVA) for the treatment of thyroid lesions with a diameter minor than 3 cm. Ten females and 2 males (mean age: 37 yr) with a cold thyroid nodule and a cytological diagnosis of microfollicular tumor were selected for MIVA hemythyroidectomy. The procedure was carried out through a 15 mm incision with needlescopic instruments and a 30 infinity 5-mm endoscope. Mean operative time was 87 min (range 60-120). No complications were registered. Cosmetical result was excellent in all patients. MIVA hemythyroidectomy is safe and effective; indications and limits of this new procedure require further studies.
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                Author and article information

                Journal
                Biomed Res Int
                Biomed Res Int
                BMRI
                BioMed Research International
                Hindawi Publishing Corporation
                2314-6133
                2314-6141
                2014
                8 April 2014
                : 2014
                : 450170
                Affiliations
                1Department of Otorhinolaryngology, Head and Neck Surgery, First Faculty of Medicine, Charles University in Prague and University Hospital Motol, V Úvalu 84, 150 06 Prague 5, Czech Republic
                2Institute of Anatomy, First Faculty of Medicine, Charles University in Prague, U Nemocnice 3, 128 00 Prague 2, Czech Republic
                3Department of Otorhinolaryngology, Head and Neck Surgery, Third Faculty of Medicine, Charles University Prague, Military Hospital, U Vojenské Nemocnice 1200, 169 00 Prague 6, Czech Republic
                4Department of Electromagnetic Field, Faculty of Electrical Engineering, Czech Technical University in Prague, Technická 2, 166 27 Prague 6, Czech Republic
                Author notes

                Academic Editor: Jan Plzák

                Author information
                http://orcid.org/0000-0001-8772-317X
                Article
                10.1155/2014/450170
                3996987
                24800227
                0b261065-af29-4e46-bb65-bb734b3e6a13
                Copyright © 2014 Zdeněk Fík et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 31 January 2014
                : 18 March 2014
                Funding
                Funded by: Charles University
                Award ID: PRVOUK/LF1/P27
                Funded by: Specific University Research
                Award ID: (SVV UK) 266513
                Funded by: Specific University Research
                Award ID: UNCE 204013
                Funded by: Ministry of Health of the Czech Republic
                Award ID: IGAMZ CR 11542
                Funded by: Ministry of Health of the Czech Republic
                Award ID: 134 88
                Funded by: European Regional Development Fund
                Categories
                Clinical Study

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