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In surgery the term "minimally invasive" was coined in 1986 by urologist John Wickham to describe a range of procedures that required making only very small incisions, or sometimes no incision at all, to treat diseases which traditionally treated by open surgery. In thyroid surgery, not much has changed after the establishment of surgical principles in the early part of the twentieth century. Surgical instruments have improved, anaesthesia developed, and safety of surgery increased to allow procedures also on fragile patients. The big challenge of thyroid surgery came when endoscopic procedures widely entered into surgery around 1990. In the first part of this book it is analysed the development of minimally invasive thyroidectomy, focusing on the technique we reckon could become the gold standard, that is the transoral endoscopic thyroidectomy with vestibular approach. In the second part we will expose our preliminary experience with this new operation.

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Lavazza, Matteo
Matteo Lavazza, MD; General Surgery Specialist. Gianlorenzo Dionigi, MD, FACS; Full Professor of Surgery.

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