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01-05-2018

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

Authors: C. Bellotti, M. Giulii Capponi, M. Cinquepalmi, G. Castagnola, S. Marchetta, F. Mallozzi, M. Pezzatini, A. Brescia

Published in: Surgical Endoscopy | Issue 5/2018

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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Title: MIVAT: the last 2 years experience, tips and techniques after more than 10 years
Authors: C. Bellotti
M. Giulii Capponi
M. Cinquepalmi
G. Castagnola
S. Marchetta
F. Mallozzi
M. Pezzatini
A. Brescia
Publication date: 01-05-2018
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 5/2018
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-017-5929-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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