Minimally Invasive Hemithyroidectomy Using a Mini Incision over the Upper Pole of Thyroid Swelling

Minimally invasive thyroid surgery, using various techniques including endoscopic and video-assisted have been reported. Thyroid surgery using a mini-incision over the upper pole of the thyroid, as a new technique is presented here. Methods: The study group comprised of 52 patients undergoing minimally invasive thyroid surgery (MITS) by open method during the period May 2005-May 2013. Data regarding patient demographics, indication for surgery, operation performed, nodule size, final pathology, and complications were recorded. The operation was carried out through a 1.5-2-cm incision placed directly over the upper pole of the swelling, and deepening the incision to visualize the superior pedicle. After ligating the superior pedicle, the finger is passed over the gland and separated from all sides. Then the thyroid is pulled up and the inferior pedicle accessed and ligated. Any bleeding points were taken care of and the wound was closed without drain. Results: Fifty two patients underwent MITS, 38 women and fourteen men. All the patients underwent hemi -thyroidectomy. The average measured incision size was 2. cm at the end of the procedure. The average nodule size was 3.2 cm, and the average thyroid lobe resected measured 4.5 cm in maximal length. Final pathology revealed follicular adenoma in51 patients and one thyroid cancer (follicular). There was one wound infection and one patient had temporary recurrent laryngeal nerve neurapraxia. Conclusion: Minimally invasive thyroid surgery with a minimal incision over the upper pole of thyroid swelling as an alternative to open thyroid surgery, using a standard cervical collar incision, is safe and feasible.