Endoskopie 2009; 18(3): 112-115

Minimally invasive endoscopic surgery of thyroid and parathyroid glands

prof. MUDr. Jan Betka, DrSc², doc. MUDr. Jaromír Astl, CSc², MUDr. Martin Chovanec, Ph.D^2,1, MUDr. Petr Lukeš², MUDr. Michal Zábrodský², doc. MUDr. Jan Plzák, Ph.D^3,2

¹ Klinika dětské neurologie 2. LF UK a FN v Motole, Praha

² Klinika otorinolaryngologie a chirurgie hlavy a krku 1. LF UK a FN v Motole, Praha

³ Anatomický ústav 1. LF UK, Praha

Endoscopic techniques were introduced to the field of thyroid and parathyroid surgery only recently. Literature describes large number

of methods and approaches. Minimally Invasive Video-assisted Thyroidectomy (MIVAT) and Minimally Invasive Video-assisted Parathyroidectomy

represent the most widely practiced techniques. Angled optics, magnification and illumination enable to perform thyroidectomy

or parathyroidectomy from minimal skin incision (≤ 3 cm) with identification and preservation of laryngeal nerves and healthy

parathyroids. Central approach is suitable for eventual bilateral surgery. These techniques can be used in only 10 % of thyroidectomies

and 25–75 % of parthyroidectomies. Main indications are selected cases of benign thyroid disorders and primary hyperparathyreosis

with solitary adenoma. Appropriately selected cases of small low risk well differentiated thyroid carcinomas limited to the gland and

elective surgery in RET mutation carriers are accepted indications nowadays too. Main advantages include improved cosmetic results,

less postoperative pain and reduced hospital stay without any difference in complication rate with the conventional approach.

Keywords: primary hyperparathyreosis, thyroid nodule, thyroid cancer, minimally invasive thyroid surgery, minimally invasive parathyroid surgery, MIVAT, MIVAP.

Published: October 16, 2009  Show citation