Feasibility of the Video-Assisted Thyroid Surgery Under Hypnosis Associated to local Anesthesia

Abstract

 Background: Video-assisted thyroidectomy (VAT) is feasible and safe compared to conventional surgery. Thyroidectomy under hypnosis associated to local anesthesia (HYLA) as an alternative to general anesthesia (GA) has been shown to be effective. However, its combination with VAT has not yet been reported. The aim of the study is to describe the feasibility of VAT under HYLA as a complete minimally invasive approach and evaluate its safety. Methods: Out of 130 consecutive patients referred for thyroidectomy and selected for VAT, 50 patients opted voluntarily for HYLA. Safety and feasibility were considered primary endpoints. Results: Twenty eight patients benefited from a total thyroidectomy (56%). The remaining patients underwent thyroid lobectomy. Median operating time was 102.5minutes (range 70-177) and 92.5minutes (range 51-143) for total thyroidectomy and lobectomy, respectively. Median time in operating room was 146.5minutes (range101-222) and 133minutes (range 96-178) for total thyroidectomy and lobectomy, respectively. Conversion from VAT to a conventional surgical approach occurred in 4 patients (8%). No conversion to GA was required. Hemodynamic parameter measurements were stable during surgery. No permanent hypocalcemia or vocal cord palsy were observed. Ninety eight percent of the patients required just one overnight stay in hospital. Conclusion: The current brief report demonstrates that the combination of VAT and HYLA is feasible without the risk of additional surgical morbidity.