Minimally Invasive Thyroid

Recent developments in minimally invasive surgery have been applied to thyroid and parathyroid disorders. These innovations have improved recuperation, decreased hospital length of stay, and decreased scar formation. Also, these operations allow patients to return to work and normal activities faster.

The principles of minimally invasive thyroidectomy include small incisions about 2 1/2 inches and no drainage tubes. Once the incision is made, the thyroid is mobilized into the wound and the vascular supply is controlled. The nerves are identified and carefully preserved prior to extracting the specimen. Most patients have little discomfort after a minimally invasive thyroidectomy and are discharged in 23 hours.

The hallmarks of minimally invasive parathyroidectomy include pre-operative imaging to identify the location of the abnormal parathyroid gland or glands, small incisions about 1 1/2 inches, minimal exploration in the neck, and parathyroid hormone measurements to guide surgery and define success. During the surgery, a small neck incision is made directly over the parathyroid pathology based on the pre-operative imaging. The parathyroid gland is mobilized into the wound and the vascular supply is controlled. As with thyroid surgery, the nerves are identified and carefully preserved.

Advantages of the Procedure

Most patients experience less pain and a faster recovery utilizing these techniques. For the most part, these techniques provide a smaller incision that fades over time and is hidden from view.

Recovery

Once the surgery is completed, most patients are discharged in 23 hours. Again, most patients can return to normal activities quickly with excellent cosmetic outcomes with minimal scars. Most patients follow up with their surgeon in 1-2 weeks and are back at work in 2 weeks.

Publications

Sidawy, M.K., DelVecchio, D.M., and Knoll, S.M. Fine-Needle Aspiration of Thyroid Nodules- Correlation between Cytology and Histology and Evaluation of Discrepant Cases Cancer Cytopath 1997; 81(4): 253-259

Hanna, W.C., Ponsky, T.A., Trachiotis, G.D., and Knoll, S.M. A Case of Colon Cancer Metastatic to the Lung and Thyroid Gland. Arch Surg 2006 Jan; 141(1): 93-96

Sadeghi, N., Akin, A., Lee, J., Roland, J. and Knoll, S. Targeted Parathyroidectomy: Effectiveness and Intraoperative Rapid-Parathormone Dynamics. Laryngoscope,118: 1997-2002, Nov 2008

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