Introduction to small incision endoscopic minimally invasive thyroidectomy technique

  Endoscopic thyroidectomy is a new surgical technique designed to minimize the trauma of neck surgery, commonly known as Minimally invasive Endoscopic Thyroidectomy (MIET). Compared with traditional surgery, it is much less invasive because it is performed through a small incision in the anterior lower neck and directly into the thyroid bed area, eliminating the need for a large incision, severing the vastus cervicis muscle and implementing a large submuscular flap as in traditional direct vision surgery. Experience has shown that postoperative neck pain is mild, inflammatory exudation is low, and swelling dissipates quickly in patients who undergo this procedure. Usually, the patient is discharged 1-2 days after the procedure.  The incision required for endoscopic thyroidectomy is only 2-4 cm long (2 cm for adenoma and unilateral nodular goiter; 3 cm for bilateral nodular goiter; 4 cm for hyperthyroidism). Compared to the 6-12 cm long incision in traditional surgery, this is three times smaller! Because of the strict positioning and fine suturing of even such a small incision, the fine thread-like scar later has minimal impact on the appearance of the neck.  The indications for endoscopic thyroidectomy operations are relatively broad. Patients with various benign thyroid lesions such as adenoma, nodular goiter and hyperthyroidism can be selected (4-5 cm incision). However, this technique is not yet available for thyroid cancer treatment due to the state of technological development. However, for those who are only suspected of having cancer (the lesion is actually more likely to be benign), an endoscopic procedure (as an exploration) can be beneficial. Once the biopsy proves that the lesion is benign, it is impossible to reduce the size of the incision already made.