Published: 2019-11-26

Feasibility of using minimal incision in thyroidectomy operation

Hossam Abdelkader El Fol, Mohamed Sabry Ammar, Mohammed A. Elbalshy, Mohamed Sobeeh


Background: The conventional technique of thyroidectomy requires long skin incision, not satisfying patient and surgeon in terms of cosmesis and endoscopic thyroid surgery requires expertise. The aim of this study was to compare the clinical outcomes of patients undergoing minimal-incision thyroidectomy with those undergoing conventional thyroidectomy for benign thyroid diseases.

Methods: Prospective randomized study that was carried on 50 patients who were undergone thyroidectomy at the department of surgery-Menoufia University from June 2018 to June 2019. The patients were divided into two groups. Group A included 25 patients who were operated upon using minimal incision thyroidectomy technique and group B included 25 patients who were undergone traditional thyroidectomy incision.

Results: The length of skin incision was significantly shorter in the minimal-incision thyroidectomy than that in the conventional thyroidectomy group. Operative time was shorter in minimal incision technique. The incidence of postoperative complications was higher in conventional thyroidectomy group but didn’t reach to significant level. Patients undergone minimal-incision thyroidectomy experienced significantly less postoperative pain and were more satisfied with the cosmetic result than patients who underwent conventional thyroidectomy.

Conclusions: Thyroid surgery can safely be performed as a minimally invasive procedure. Minimal access thyroid surgery is therefore a feasible and safe option for selected patients with excellent cosmetic outcome, with minimal learning curve.


Minimal incision thyroidectomy, Benign thyroid disease, Numerical score system

Full Text:



Narayanrao CN, Govindrao SP, DangeAN, Sarda A. Is Minimal Incision Thyroid Surgery a better alternative to Conventional and Endoscopic Thyroid Surgery for Solitary Thyroid Nodule? J Evidence Med Healthcare. 2014;1(11):1436-44.

Ikeda Y, Takami H, Sasaki Y, Takayama J-i, Kurihara H. Are there significant benefits of minimally invasive endoscopic thyroidectomy? World J Surg. 2004;28(11):1075-8.

Elgamaal AS, Fayed A, Elbalshy MA, Aziz MM. Evaluation of intracapsular total thyroidectomy as a safe method in benign thyroid diseases. Int Surg J. 2019;6(8):2682-5.

Seybt MW, Terris DJ. Minimally invasive thyroid surgery in children. The Annals of Otology, Rhinol Laryngol. 2011;120(4):215.

Brunaud L, Zarnegar R, Wada N, Ituarte P, Clark OH, Duh QY. Incision length for standard thyroidectomy and parathyroidectomy: when is it minimally invasive? Arch Surg. 2003;138(10):1140-3.

Sabuncuoglu MZ, Sabuncuoglu A, Sozen I, Benzin MF, Cakir T, Cetin R. Minimally invasive surgery using mini anterior incision for thyroid diseases: A prospective cohort study. Int J Clin Experimental Med. 2014;7(10):3404.

Alvarado R, McMullen T, Sidhu SB, Delbridge LW, Sywak MS. Minimally invasive thyroid surgery for single nodules: an evidence-based review of the lateral mini-incision technique. World J Surg. 2008;32(7):1341-8.

El-Fol HA, Gouda I, Tabashy R, Kamel MM. Ultrasound directed minimally invasive incision for parathyroidectomy of the parathyroid adenoma (An initial experience). Ain-shams J Surg. 2014;76(3):271-82.

Park CS, Chung WY, Chang HS. Minimally invasive open thyroidectomy. Surg Today. 2001;31:665-9.

Del Rio P, Berti M, Sommaruga L, Arcuri M, Cataldo S, Sianesi M. Pain after minimally invasive videoassisted and after minimally invasive open thyroidectomy—results of a prospective outcome study. Langenbeck's Arch Surg. 2008;393(3):271-3.

Gosnell JE, Sackett WR, Sidhu S, Sywak M, Reeve TS, Delbridge LW. Minimal access thyroid surgery: technique and report of the first 25 cases. ANZ J Surg. 2004;74(5):330-4.

Perigli G, Qirici E, Badii B, Kokomani A, Staderini F, Luconi M, et al. Feasibility and safety of minimal‐incision thyroidectomy for Graves' disease: A prospective, single‐center study. Head Neck. 2013;35(9):1345-8.

Govednik CM, Snyder SK, Quinn CE, Saxena S, Jupiter DC. Minimally invasive, nonendoscopic thyroidectomy: A cosmetic alternative to robotic-assisted thyroidectomy. Surgery. 2014;156(4):1030-8.

Sywak MS, Yeh MW, McMullen T, Stalberg P, Low H, Alvarado R, et al. A randomized controlled trial of minimally invasive thyroidectomy using the lateral direct approach versus conventional hemithyroidectomy. Surgery. 2008;144(6):1016-22.

Terris DJ, Bonnett A, Gourin CG, Chin E. Minimally invasive thyroidectomy using the Sofferman technique. The Laryngoscope. 2005;115(6):1104-8.‏

Rafferty M, Miller I, Timon C. Minimal incision for open thyroidectomy. Otolaryngol Head Neck Surg. 2006;135(2):295-8.