The use of electrothermal bipolar vessel sealing system in minimally invasive video-assisted thyroidectomy (MIVAT)

Purpose: Options for controlling hemostasis during endoscopic thyroid surgery include vessel clips and ultrasonic technology. The aim of this study was to evaluate the use of the electrothermal bipolar vessel sealing system on the performance of minimally invasive video-assisted thyroidectomy (MIVAT). Methods: Between January 2006 and July 2007, 63 consecutive patients underwent MIVAT. The operative time, complications, and hospital stay were analyzed prospectively. As endoscopic instruments are important variables for incision length, the mini-incision was routinely measured at the end of the endoscopic procedure and compared with the initial standard approach (ie, 1.5 cm). Results: The mean operative time for lobectomy was 49.5 minutes (range, 39 to 120) and for total thyroidectomy 97.6 (59 to 130) minutes. No cases required conversion to open surgery and none involved significant intraoperative complications. Postoperative recovery was uneventful in all procedures. All patients were satisfied with the cosmetic results. At the end of the procedure, the mean length of the incision was not significantly increased. Conclusions: This study showed that the utilization of electrothermal bipolar vessel sealing system for MIVAT is feasible and safe. A reduction of the rates for postoperative complications such as hypoparathyroidism and recurrent laryngeal nerve injuries was not possible to demonstrate in the present study.