2016 Volume 26 Issue 1 Pages 83-89
Background: The aim of this study was to evaluate the feasibility and outcomes of video-assisted total thyroidectomy for Graves' disease.
Methods: Between May 2009 and October 2015, a total of 192 patients with thyroid diseases underwent thyroid surgery by video-assisted neck surgery (VANS method). Among these patients, 13 underwent total thyroidectomy for Graves' disease. We had modified the VANS method mainly by using an originally-developed skin-flap retractor. In our modified method, the main incision of 2.5cm was made on the right side of the chest wall below the clavicle, then the newly-developed retractor was inserted under the subplatysmal layer to create working space. An endoscope was inserted via 5-mm ports on both sides of the neck. The intraoperative nerve monitoring system identified bilateral recurrent laryngeal nerves in all patients.
Results: The operation was successfully completed endoscopically in all patients. The median value of preoperative estimated thyroid volume, operating time, and postoperative hospitalized period were 26ml, 180 minutes, and 3 days, respectively. As complications, two patients had transient unilateral laryngeal paralysis that recovered in a month and two patients had transient hypocalcemia.
Conclusion: Although total thyroidectomy for Graves' disease by the modified VANS method may be contraindicated for large thyroids, it is feasible and safe with excellent cosmetic results.
