The Learning Curve of Video‐Assisted Thyroidectomy

Abstract

Objective: Minimally invasive video-assisted thyroidectomy (MIVAT) has been demonstrated to be a safe procedure for the removal of small thyroid nodules in order to improve cosmetic results and reduce pain. The aim of this study was to evaluate the learning curve of this procedure. Method: Thirty-four patients were consecutively operated by MIVAT and were arbitrarily split in 2 groups: group 1 (n = 17) for the first 17 patients who underwent MIVAT and group 2 (n = 17) for the following 17 patients. MIVAT was performed through a unique cervical incision of 2 cm length. Results: Twenty-one lobectomies and 13 total thyroidectomies were performed. The mean operative time was significantly shorter in group 2 (59 ± 22 min) than in group 1 (81 ± 33 min) ( P = .03). There was neither significant difference between groups for the occurrence of postoperative complications nor for the other outcome measurements: scar length was 2.1 ± 0.2 cm and 1.85 ± 0.4 cm in group 1 and 2 respectively, postoperative pain was 2.7 ± 1.5 and 2.2 ± 1.8 in group 1 and 2 respectively, and the mean time of hospital stay was 2.8 ± 1.0 days. Conclusion: MIVAT requires a learning curve. This study showed that the surgical time was significantly shortened with experience. Recommendations should define the number of lobectomies and the training program to be performed for the surgeon and assistants in order to lower mean operative time and reduce complications for MIVAT.