Modifications of Miccoli minimally invasive thyroidectomy for the low-volume surgeon

David J Terris, Melanie W. Seybt

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective: The objective of the study was to describe our experience with modifications of the Miccoli minimally invasive thyroidectomy. Design: Planned analysis of a prospectively maintained database was undertaken after Institutional Review Board approval. Methods: Demographic and surgical data were obtained and analyzed with attention to age, sex, pathology, incision lengths, and complications. Results: From a single-surgeon series of 785 consecutive thyroidectomies, 178 patients were identified who underwent an endoscopic minimally invasive thyroidectomy. A series of modifications of the classic Miccoli technique evolved over a period of 4 years and include presurgical factors (patient marking in holding area, intubation with laryngeal EMG tube using videolaryngoscope, rotation of operating table away from anesthesia), intraoperative principles (use of operative loupes, slave monitor, laryngeal nerve monitoring, and novel instrumentation; identification of the medial cleft and ligation of superior pedicle bundle using ultrasonic technology; avoidance of clips), and postoperative techniques (deep extubation, laryngeal endoscopy, outpatient management, and oral calcium supplementation). Conclusions: A minimally invasive endoscopic thyroidectomy is possible even in a practice with moderate surgical volumes by using several techniques that facilitate the performance of this procedure. A high success rate and low complication rate can be achieved, resulting in improved patient satisfaction.

Original languageEnglish (US)
Pages (from-to)392-397
Number of pages6
JournalAmerican Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume32
Issue number5
DOIs
StatePublished - Sep 1 2011

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Thyroidectomy
Operating Tables
Laryngeal Nerves
Research Ethics Committees
Patient Satisfaction
Surgical Instruments
Intubation
Ultrasonics
Endoscopy
Ligation
Outpatients
Anesthesia
Demography
Databases
Pathology
Calcium
Technology
Surgeons

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Modifications of Miccoli minimally invasive thyroidectomy for the low-volume surgeon. / Terris, David J; Seybt, Melanie W.

In: American Journal of Otolaryngology - Head and Neck Medicine and Surgery, Vol. 32, No. 5, 01.09.2011, p. 392-397.

Research output: Contribution to journalArticle

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