Minimally Invasive Open Thyroidectomy: A Safer Approach in the Era of Minimally Invasive Surgery-A Case Series

Abstract

Complications related to the conventional thyroidectomy like the long scar in front of the neck, paraesthesia, hyperesthesia, voice changes, and dysphagia is still the matter of concern with conventional thyroidectomy (CT). Due to all these complications, minimally invasive surgery of head and neck is becoming popular nowadays. Advantages of minimally invasive thyroidectomy surgery (MITS) over CT cosmesis, less post-operative pain, shorter hospital stay and better functional outcomes (in terms of voice and swallowing).  A thyroidectomy performed with incision of less than 3.5 cm, without endoscope is term as the minimally invasive open Thyroidectomy (MIOT) or minimally invasive or non-endoscopic thyroidectomy (MINET). Since Dec 2011 we performed seven MIOT. All patients were female aged between 16-40 years. All seven patients had unilateral thyroid swelling and the size ranging from 3.3 × 2.8 to 4×4 cm.  In the first three patients,  we made an incision of 3.5 cm but thereafter we reduced the length of the incision to 2.5 cm. Operating time was ranging from 107 minutes to 56 mins. Except for the superficial thermal burn at the skin edge, no other complications were encountered in our series. Hospital stay was between 1 -2 days. VAS score was 1 in all patients except the first patient who sustained a thermal injury. She had a VAS score of 2. We used a simple four parameters score: Excellent, Good, Fair and poor. Except for this patient all patient has very minimal pain and good remarks for the cosmetic outcome. With the improvement in our surgical techniques, our incision length, and duration of surgery reduced in subsequent cases. Minimally Invasive thyroidectomy is a safe procedure and as it does not require any special equipment and training it can be done in any centers irrespective of hospital infrastructure.