1. VIDEO-ASSISTED
OPERATIONS IN THYROID
SURGERY
BY
ABHISHEK GONGALE
501

2. "FIRST EXPERIENCE" OF VIDEO-ASSISTED
OPERATIONS
1996 Gagner - first endoscopic parathyroid surgery
1997 Huscher - the first endoscopic thyroid surgery
1999 Miccoli – minimally invasive surgery with a video
assistant
Michel Gagner
Paolo Miccoli

3. INDICATIONS FOR INTERVENTION
• Diffuse toxic goiter (Graves' disease)
• Follicular tumor
• Any malignancy
• Large goiter with symptoms of compression of the
trachea and esophagus.
• Reappearance of cystic formation.

4. INDICATIONS FOR ENDOSCOPIC THYROID SURGERY
• Presence of thyroid nodules less than 35mm
The volume of the thyroid gland is less than 25 ml.
• No history of neck surgery.

5. ADVANTAGES OF VIDEO-ASSISTED INTERVENTIONS
•Good cosmetic effect.
•Preservation of surrounding anatomical structures:
parathyroid glands and recurrent laryngeal nerve.
•Reducing the duration of inpatient treatment and
disability (postoperative period).
•Small tissue trauma.
•Decreased pain syndrome.

7. •assisted thyroidectomy or MIVAT is a method of
removing the thyroid gland using endovideosurgical
instruments and a minimally invasive mini-access.
Such operations on the thyroid gland are of a low-
traumatic nature, because during their implementation
all manipulations are controlled by video equipment.
That is why they are called video-assisted .

8. VIDEO-ASSISTED OPERATIONS
• Hemithyroidectomy (removal of the isthmus and/or lobe of
the thyroid gland)
• Thyroidectomy (total removal of follicular tissue)
• Resection (partial removal of affected areas) areas)

9. • Good lighting and an increase in the operating
field allows visualization of the recurrent nerve
and parathyroid glands and control of their
condition. The stages of the operation include:
access to the thyroid tissue, mobilization and
processing of vascular structures, removal of
thyroid tissue of the required volume, control
of hemostasis, suturing of the postoperative
wound .

10. MINIMALLY INVASIVE APPROACHES
1) Median cervical
2) Lateral cervical
3) Anterior thoracic
4) paraareolar
5) Axillary
6) submandibular

12. COSMETIC RESULT OF VIDEO-ASSISTED THYROIDECTOMY
Cosmetic results
the next day after surgery.
Cosmetic result
one month after the
operation .
Cosmetic result
2 months after surgery

13. POSTOPERATIVE COMPLICATIONS
•Dysphonia and voice change. The risk of this complication is
less with lobectomy than with thyroidectomy.
•Hypoparathyroidism develops when the parathyroid glands are
mistakenly removed or damaged during a total thyroidectomy.
•Possible damage to nerves or ligaments;
•Infectious lesions of the wound;
•bleeding;
•Hypothyroidism caused by a deficiency of thyroid hormones.

14. Thank you for your attention !