الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 153 |  |  |
| | | from | 153 | | |
Abstract
SUMMARY
C
onventional thyroid surgery does not satisfy patients who are concerned with esthetic point of view, this lead to evolution of minimally invasive thyroid surgery.
This study compared different approaches of minimally invasive thyroid surgery and the applicability in Egypt as a developing country.
We started by; Mini incision thyroidectomy which carried out through an incision as small as 2.5 cm. The principle of MATS (minimal access thyroid surgery) is that a small (2.5 cm) lateral incision is placed, directly over the nodule, with mobilization of the subplatysmal and deeper tissues to allow the skin incision to be moved around the neck, and over the relevant area of dissection. A hemithyroidectomy can thus be performed with as much exposure as is achieved in an open thyroidectomy via a formal collar incision, except that the exposure is carried out in stages.
In our study 108 patients underwent MATS with results better than conventional thyroidectomy and lesser complications than endoscopic thyroidectomy.
Thus we concider it a good alternative to the conventional procedure.
The second type of minimally invasive thyroid surgery is Minimally Invasive video assisted thyroid surgery minimally invasive video-assisted thyroidectomy (MIVAT) typically involves a skin incision no greater than 3 cm that is placed slightly higher than the conventional thyroidectomy incision. Open dissection is carried out until the superior thyroid pole is encountered, after which the endoscopic video-assisted techniques are used.
It is a good option for tertiary hospitals as it needs training and high cost.
Then come to options not applicable in Egypt they are True endoscopic and robotic both of them need very high cost and training with high incidence of complications during 1st trials.
Endoscopic Thyroidectomy belongs to a type of minimally invasive procedure called Video Assisted Neck Surgery (VANS). This is a very new procedure that is also technically demanding. VANS uses small telescopes and fine instruments to operate on structures in the neck such as the thyroid and parathyroid glands. Because the neck has no anatomical potential space, the first thing we do is to create a working space under the neck using dissection and inflation with carbon dioxide.
A 10 mm incision is used to insert the telescope and to remove the specimen at the end of the operation. Two or three smaller incisions (2mm to 5 mm in size) are used to for the instruments. All the incisions are placed either in the neck, over the chest or in the armpit