Journal of Obesity & Weight Loss Therapy
Open Access

Abstract

Surgical indications for thyroid diseases are various, due to increased gland volume, hyperthyroidism, benign nodules or cancer. Patients have many differencies among them, ranging from child to older, with or without comorbidity, from thin to obese patients. Thyroidectomy has been performed by the same traditional open technique for more than a century, for every kind of person and any disease. Guidelines for malignancy have been recently modified and technogical advances has developed new opportunities. Energy based devices, innovative hemostatic patches, radiofrequency ablation, HD-3D technology, 4K resolution, near infra-red (NIR) fluorescence, minimal invasive techniques, robotic procedure or trans-oral approach are now available. 3D HD-Esoscope assisted thyroidectomy is the newest way to perform the open procedure: the intervention is video-assisted using a HD 3D esoscope which allows a great magnification of laringeal nerves and parathyroid glands: combining it with NIR fluorescence all four parathyroid can be identified in almost all of cases. Minimal invasive videoassisted thyroidectomy (MIVAT) is performed by a HD camera through a 15mm incision in the neck: safety, accuracy and oncological radicality have been widely demonstrated. Robotic thyroidectomy is performed through a 5cm axillary incision; in expert hands allows safety, accuracy and oncological radicality. TransOral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) is a completely scarless new technique, a NOTES procedure. It is carried out by three port insertion in the oral vestibule, creating a working space in the neck by CO2 insufflation and ending the suture-less intervention entirely by energy based devices. Few centres in the world are using this technique nowaday, but it seems to be very promising. The lecture will emphasize that Endocrine Surgeon must have different choices for different patients, tailored to the thyroid indication, age, gender, weight, other diseases, therapies, voice-depending jobs, surgeon skills and experience, hospital volume and budget.

Biography

Andrea Casaril is a Chief of Endocrine Unit of Pederzoli Hospital, Peschiera del Garda, Verona. He is an expert in minimal invasive surgery (laparoscopic surgery, minimal invasive thyroid surgery, trans-oral thyroidectomy), thyroid surgery, gallbladder VL surgery, open and VL abdominal reconstruction surgery, laparoscopic colorectal surgery and liver surgery. He has done more than 3000 surgical interventions as first operator.

E-mail: andrea.casaril@yahoo.it