Minimally invasive surgery of thyroids and parathyroids

Abstract

The term minimally invasive surgery of thyroids and parathyroids encompasses a series of therapeutic procedures aimed at solving the endocrinal pathology responsible for the disease, with limited surgical aggression and aesthetic results and postoperative comfort on a par with the conventional approach. Its application has become possible with the development of new methods of imaging and instruments that make it possible to carry out dissection in very limited spaces. Unlike classical surgery of thyroids and parathyroids, where surgical technique has broad possibilities of application, in the cerviscopic approach the indications are more limited and a relationship is established with the characteristics of each patient. With respect to thyroidal pathology, the size of the nodule constitutes the main limiting factor, since in sizes above 3 cm the benefits of the procedure are not so apparent. However, greater potential is available in parathyroidal surgery given that the adenoma responsible for the disease is frequently found in anatomical positions that are very accessible for this type of procedure. Thus, in patients with an absence of associated thyroidal pathology, with a unilateral pathology based on the information of the sestamibi scan and preferably in lower localisations, the cerviscopic approach can meet the requirements of efficiency, postoperative comfort and short hospital stay.