Abstract
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.