Surgery News - August 2007 - (Page 18)

18 HEAD AND NECK SURGERY NEWS • A U G U S T 2 0 0 7 Minimally Invasive Thyroidectomy Seen as Safe BY DOUG BRUNK Else vier Global Medical Ne ws S A N D I E G O — A study of minimally invasive video-assisted thyroidectomy conducted at four academic surgery centers in North America found an overall complication rate of 7%, Dr. David J. Terris reported at the annual meeting of the American Head and Neck Society. “It appears that the safety of the procedure is not compromised. Therefore, we endorse a cautious expansion in the application of this approach,” said Dr. Terris, the study’s principal investigator. Advantages of minimally invasive video-assisted thyroidectomy, compared with open surgery, include superior visualization, minimal incision size, and reduced dissection. Disadvantages include the fact that it requires additional equipment and two surgery assistants, and that it takes 20%-30% longer to perform than conventional surgery. “A hemithyroidectomy takes approximately an hour, and a total thyroidectomy can be done in about 1 hour and 45 minutes,” said Dr. Terris, professor and chairman of otolaryngology at the Medical College of Georgia, Augusta, and an ACS Fellow. The technique was introduced in Europe in 1998 but has only recently been adopted by selected North American centers. Dr. Terris and his associates at the University of Chicago, the University of Cincinnati, and Loma Linda (Calif.) University set out to evaluate the feasibility of this approach in high-volume thyroid treatment centers, determine the inci- A M E R I C A N C O L L E G E O F S U R G E O N S • D I V I S I O N O F E D U C AT I O N Education presents the Personal Financial Planning and Management Course for Residents and Young Surgeons, which uses an dence of complications, and validate previously published single-center reports. Patients eligible for the procedure included nonobese individuals with a thyroid nodule size of 2.5-3.0 cm, a normal-size thyroid gland (20 cc or smaller), and no preoperative evidence of thyroiditis. Of the 228 eligible patients, 12 were converted to open surgery. Of the open surgery patients, eight had too large a thyroid Safety is not nodule, two had compromised, unanticipated invaso we endorse a cautious expansion sive cancer, one developed significant in the application thyroiditis, and one of this approach. experienced lithiDR. TERRIS um-induced goiter. Of the 216 patients included in the final analysis, most (88%) were female, and their mean age was 44 years. The mean incision length was 28 mm. There were no hematomas, no cases of permanent hypocalcemia, and no vocal cord paralysis. However, nine patients had temporary hypocalcemia, and five patients had temporary vocal cord paresis. One patient required scar revision, and one patient had an altered pitch following surgery. Dr. Terris disclosed that he serves as a paid consultant for Medtronic Xomed and has directed thyroid courses sponsored by Ethicon Endo-Surgery. ■ A mean incision length of 28 mm was used in removal of the thyroid. DR. DAVID J. TERRIS Objectives At the end of the course, the participants will be able to describe: Longer operative time is required, but the postsurgical scar is minimal. INDEX OF ADVERTISERS General Scientific Corporation SurgiCam 9 13 5 19-20 Intended audience: KCI V.A.C. Tissue Science Laboratories, Inc. Permacol Wyeth Pharmaceuticals Inc. TYGACIL PHOTOS COURTESY http://www.acs-resource.org

Table of Contents Feed for the Digital Edition of Surgery News - August 2007

Contents Drug Developments News From the College Thoracic Surgery Head & Neck Surgery

Surgery News - August 2007

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