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Minimally Invasive Video-Assisted Thyroidectomy (MIVAT)

MIVAT is a minimally invasive technique that allows total thyroidectomy through a 1.5-3 cm cervical incision with the assistance of a video endoscope.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Minimally Invasive Video-Assisted Thyroidectomy (MIVAT)?

MIVAT was developed by Miccoli et al. (1998) and is now performed worldwide. It allows total thyroidectomy with a 1.5-3 cm cervical incision (5-7 cm in conventional surgery) and the assistance of a video endoscope.

Patient selection criteria: thyroid volume <25 mL (US), main nodule <35 mm, no thyroiditis (Hashimoto/Graves), no previous neck surgery, no extensive lymphadenopathy. Best candidates: small benign nodules, microcarcinoma (<1 cm).

Surgical technique: 1.5-3 cm collar incision → blunt dissection of strap muscles → 5 mm endoscope assistance → vessel sealing devices (Harmonic, LigaSure) → recurrent laryngeal nerve and parathyroid identification → lobectomy or total thyroidectomy. Operative time 60-90 minutes. Conversion rate <2%. Cosmetic VAS score significantly higher.

Symptoms

Palpable thyroid nodule (often asymptomatic)
Cosmetic concern (especially in young women)
Compressive symptoms (large goiters)
Hyperthyroid symptoms (toxic nodule)
Hoarseness (rare)
Cervical pain

Risk Factors

Bethesda IV-V cytology (suspicious for malignancy)
Microcarcinoma (PTC <1 cm)
Toxic adenoma (Graves disease excluded)
Hashimoto's thyroiditis (relative contraindication)
Compressive symptomatic small goiter
Patient cosmetic preference

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Surgical indication for thyroid nodule
  • Cosmetic concern (especially in young patients)
  • Bethesda IV-V cytology
  • Microcarcinoma diagnosis
  • Toxic adenoma (medical treatment failure)
  • MIVAT candidate evaluation

Treatment Methods

01
Pre-op US: thyroid volume + nodule size measurement
02
Patient selection (volume <25 mL, nodule <35 mm)
03
1.5-3 cm collar incision
04
Video endoscope assistance + vessel sealing
05
RLN + parathyroid identification (mandatory)
06
Postop calcium + RLN check (24h)

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.