SUMMARY AND CONCLUSIONThe solitary thyroid nodule is defined as a single discrete mass in an otherwise impalpable gland, whereas the preferred term for a similar swelling in a gland with clinical evidence of generalized abnormality in the form of a palpable contra-lateral lobe or generalized mild nodularity is “dominant”.Solitary thyroid nodules present in approximately 4 percent of individuals, however single nodules are about four times more common in women than in men. The mean age of incidence was 20 to 60 years old.Surgical trends have been directed toward less invasive procedures, especially since the establishment of laparoscopic cholecystectomy. Endoscopic procedures are being applied in various fields because they produce less pain and better cosmetic results.Thyroidectomy is a procedure that can be safely performed in most clinical settings and therefore it is difficult to define why one should perform it by a minimally invasive approach and which advantages one should expect from these techniques. However, a minimally invasive approach should guarantee better cosmetic results. This is particularly true when dealing with small nodules, which would have to be retrieved by traditional cervicotomy, leaving an unnecessarily large scar. This is very important because the majority of patients are young women, for whom the esthetic appearance is very important. Furthermore the minimally invasive approach should also provide a better postoperative course, reducing postoperative pain and discomfort.This study was carried on twenty patients with solitary thyroid nodule who were admitted to the general surgery department, Zagazig university hospital, during the period from September 2004 to august 2005. to assess the video-assisted endoscopy as a new technique in management of solitary thyroid nodule, and to compare it with conventional thyroidectomy. The patients were 16 females and 4 males. Their ages range between 18 and 45 years with a mean age of 26 years. 8 patients were treated with assisted endoscopic thyroidectomy (7 females and a male), the other 12 patients were treated with conventional thyroidectomy (9 females and 3 males).The challenge of the video-assisted approach is to be able to perform a thyroid lobectomy (or a total thyroidectomy) in a minimally invasive way, using the same technique as for conventional surgery to guarantee safe control of the vascular pedicles and to localize and avoid damage to the parathyroid glands and recurrent laryngeal nerve.All the patients have been subjected to the following preoperative assessment : full history sheet was taken from each case, general examination, local examination of the neck region, indirect laryngoscopy for evaluation of vocal cords mobility, laboratory investigation in the form of routine investigation (as, complete blood picture, liver function tests, kidney function tests, PT, PTT and ESR), serum T3, T4 and TSH, neck ultrasound, FNAC of the thyroid nodule with sonar guided and thyroid scanning (Tcm99) for selected cases.The patients were divided to two groups:Group I (n = 12) were submitted for conventional thyroidectomy.Group II (n = 8) were submitted for video-assisted endoscopic thyroidectomy.In Conclusion, Minimally invasive video-assisted thyroid surgery is an innovative, attractive, and promising approach for the surgical treatment of small thyroid lesions. The procedure is safe, requiring only simple instrumentation, but it also requires a precise and gentle surgical technique that follows the same surgical rules as the classical approach. This technique yields excellent results in terms of cosmoses and the postoperative patient comfort.Although larger series of patients will be necessary before deciding to introduce minimally invasive thyroid surgery in selected centers. It can be concluded that MIVAT is a safe procedure offering some advantages to patients who, at present, still represent only a minority whom undergo thyroid surgery.SUMMARY AND CONCLUSIONThe solitary thyroid nodule is defined as a single discrete mass in an otherwise impalpable gland, whereas the preferred term for a similar swelling in a gland with clinical evidence of generalized abnormality in the form of a palpable contra-lateral lobe or generalized mild nodularity is “dominant”.Solitary thyroid nodules present in approximately 4 percent of individuals, however single nodules are about four times more common in women than in men. The mean age of incidence was 20 to 60 years old.Surgical trends have been directed toward less invasive procedures, especially since the establishment of laparoscopic cholecystectomy. Endoscopic procedures are being applied in various fields because they produce less pain and better cosmetic results.Thyroidectomy is a procedure that can be safely performed in most clinical settings and therefore it is difficult to define why one should perform it by a minimally invasive approach and which advantages one should expect from these techniques. However, a minimally invasive approach should guarantee better cosmetic results. This is particularly true when dealing with small nodules, which would have to be retrieved by traditional cervicotomy, leaving an unnecessarily large scar. This is very important because the majority of patients are young women, for whom the esthetic appearance is very important. Furthermore the minimally invasive approach should also provide a better postoperative course, reducing postoperative pain and discomfort.This study was carried on twenty patients with solitary thyroid nodule who were admitted to the general surgery department, Zagazig university hospital, during the period from September 2004 to august 2005. to assess the video-assisted endoscopy as a new technique in management of solitary thyroid nodule, and to compare it with conventional thyroidectomy. The patients were 16 females and 4 males. Their ages range between 18 and 45 years with a mean age of 26 years. 8 patients were treated with assisted endoscopic thyroidectomy (7 females and a male), the other 12 patients were treated with conventional thyroidectomy (9 females and 3 males).The challenge of the video-assisted approach is to be able to perform a thyroid lobectomy (or a total thyroidectomy) in a minimally invasive way, using the same technique as for conventional surgery to guarantee safe control of the vascular pedicles and to localize and avoid damage to the parathyroid glands and recurrent laryngeal nerve.All the patients have been subjected to the following preoperative assessment : full history sheet was taken from each case, general examination, local examination of the neck region, indirect laryngoscopy for evaluation of vocal cords mobility, laboratory investigation in the form of routine investigation (as, complete blood picture, liver function tests, kidney function tests, PT, PTT and ESR), serum T3, T4 and TSH, neck ultrasound, FNAC of the thyroid nodule with sonar guided and thyroid scanning (Tcm99) for selected cases.The patients were divided to two groups:Group I (n = 12) were submitted for conventional thyroidectomy.Group II (n = 8) were submitted for video-assisted endoscopic thyroidectomy.In Conclusion, Minimally invasive video-assisted thyroid surgery is an innovative, attractive, and promising approach for the surgical treatment of small thyroid lesions. The procedure is safe, requiring only simple instrumentation, but it also requires a precise and gentle surgical technique that follows the same surgical rules as the classical approach. This technique yields excellent results in terms of cosmoses and the postoperative patient comfort.Although larger series of patients will be necessary before deciding to introduce minimally invasive thyroid surgery in selected centers. It can be concluded that MIVAT is a safe procedure offering some advantages to patients who, at present, still represent only a minority whom undergo thyroid surgery.SUMMARY AND CONCLUSIONThe solitary thyroid nodule is defined as a single discrete mass in an otherwise impalpable gland, whereas the preferred term for a similar swelling in a gland with clinical evidence of generalized abnormality in the form of a palpable contra-lateral lobe or generalized mild nodularity is “dominant”.Solitary thyroid nodules present in approximately 4 percent of individuals, however single nodules are about four times more common in women than in men. The mean age of incidence was 20 to 60 years old.Surgical trends have been directed toward less invasive procedures, especially since the establishment of laparoscopic cholecystectomy. Endoscopic procedures are being applied in various fields because they produce less pain and better cosmetic results.Thyroidectomy is a procedure that can be safely performed in most clinical settings and therefore it is difficult to define why one should perform it by a minimally invasive approach and which advantages one should expect from these techniques. However, a minimally invasive approach should guarantee better cosmetic results. This is particularly true when dealing with small nodules, which would have to be retrieved by traditional cervicotomy, leaving an unnecessarily large scar. This is very important because the majority of patients are young women, for whom the esthetic appearance is very important. Furthermore the minimally invasive approach should also provide a better postoperative course, reducing postoperative pain and discomfort.This study was carried on twenty patients with solitary thyroid nodule who were admitted to the general surgery department, Zagazig university hospital, during the period from September 2004 to august 2005. to assess the video-assisted endoscopy as a new technique in management of solitary thyroid nodule, and to compare it with conventional thyroidectomy. The patients were 16 females and 4 males. Their ages range between 18 and 45 years with a mean age of 26 years. 8 patients were treated with assisted endoscopic thyroidectomy (7 females and a male), the other 12 patients were treated with conventional thyroidectomy (9 females and 3 males).The challenge of the video-assisted approach is to be able to perform a thyroid lobectomy (or a total thyroidectomy) in a minimally invasive way, using the same technique as for conventional surgery to guarantee safe control of the vascular pedicles and to localize and avoid damage to the parathyroid glands and recurrent laryngeal nerve.All the patients have been subjected to the following preoperative assessment : full history sheet was taken from each case, general examination, local examination of the neck region, indirect laryngoscopy for evaluation of vocal cords mobility, laboratory investigation in the form of routine investigation (as, complete blood picture, liver function tests, kidney function tests, PT, PTT and ESR), serum T3, T4 and TSH, neck ultrasound, FNAC of the thyroid nodule with sonar guided and thyroid scanning (Tcm99) for selected cases.The patients were divided to two groups:Group I (n = 12) were submitted for conventional thyroidectomy.Group II (n = 8) were submitted for video-assisted endoscopic thyroidectomy.In Conclusion, Minimally invasive video-assisted thyroid surgery is an innovative, attractive, and promising approach for the surgical treatment of small thyroid lesions. The procedure is safe, requiring only simple instrumentation, but it also requires a precise and gentle surgical technique that follows the same surgical rules as the classical approach. This technique yields excellent results in terms of cosmoses and the postoperative patient comfort.Although larger series of patients will be necessary before deciding to introduce minimally invasive thyroid surgery in selected centers. It can be concluded that MIVAT is a safe procedure offering some advantages to patients who, at present, still represent only a minority whom undergo thyroid surgery.SUMMARY AND CONCLUSIONThe solitary thyroid nodule is defined as a single discrete mass in an otherwise impalpable gland, whereas the preferred term for a similar swelling in a gland with clinical evidence of generalized abnormality in the form of a palpable contra-lateral lobe or generalized mild nodularity is “dominant”.Solitary thyroid nodules present in approximately 4 percent of individuals, however single nodules are about four times more common in women than in men. The mean age of incidence was 20 to 60 years old.Surgical trends have been directed toward less invasive procedures, especially since the establishment of laparoscopic cholecystectomy. Endoscopic procedures are being applied in various fields because they produce less pain and better cosmetic results.Thyroidectomy is a procedure that can be safely performed in most clinical settings and therefore it is difficult to define why one should perform it by a minimally invasive approach and which advantages one should expect from these techniques. However, a minimally invasive approach should guarantee better cosmetic results. This is particularly true when dealing with small nodules, which would have to be retrieved by traditional cervicotomy, leaving an unnecessarily large scar. This is very important because the majority of patients are young women, for whom the esthetic appearance is very important. Furthermore the minimally invasive approach should also provide a better postoperative course, reducing postoperative pain and discomfort.This study was carried on twenty patients with solitary thyroid nodule who were admitted to the general surgery department, Zagazig university hospital, during the period from September 2004 to august 2005. to assess the video-assisted endoscopy as a new technique in management of solitary thyroid nodule, and to compare it with conventional thyroidectomy. The patients were 16 females and 4 males. Their ages range between 18 and 45 years with a mean age of 26 years. 8 patients were treated with assisted endoscopic thyroidectomy (7 females and a male), the other 12 patients were treated with conventional thyroidectomy (9 females and 3 males).The challenge of the video-assisted approach is to be able to perform a thyroid lobectomy (or a total thyroidectomy) in a minimally invasive way, using the same technique as for conventional surgery to guarantee safe control of the vascular pedicles and to localize and avoid damage to the parathyroid glands and recurrent laryngeal nerve.All the patients have been subjected to the following preoperative assessment : full history sheet was taken from each case, general examination, local examination of the neck region, indirect laryngoscopy for evaluation of vocal cords mobility, laboratory investigation in the form of routine investigation (as, complete blood picture, liver function tests, kidney function tests, PT, PTT and ESR), serum T3, T4 and TSH, neck ultrasound, FNAC of the thyroid nodule with sonar guided and thyroid scanning (Tcm99) for selected cases.The patients were divided to two groups:Group I (n = 12) were submitted for conventional thyroidectomy.Group II (n = 8) were submitted for video-assisted endoscopic thyroidectomy.In Conclusion, Minimally invasive video-assisted thyroid surgery is an innovative, attractive, and promising approach for the surgical treatment of small thyroid lesions. The procedure is safe, requiring only simple instrumentation, but it also requires a precise and gentle surgical technique that follows the same surgical rules as the classical approach. This technique yields excellent results in terms of cosmoses and the postoperative patient comfort.Although larger series of patients will be necessary before deciding to introduce minimally invasive thyroid surgery in selected centers. It can be concluded that MIVAT is a safe procedure offering some advantages to patients who, at present, still represent only a minority whom undergo thyroid surgery.SUMMARY AND CONCLUSIONThe solitary thyroid nodule is defined as a single discrete mass in an otherwise impalpable gland, whereas the preferred term for a similar swelling in a gland with clinical evidence of generalized abnormality in the form of a palpable contra-lateral lobe or generalized mild nodularity is “dominant”.Solitary thyroid nodules present in approximately 4 percent of individuals, however single nodules are about four times more common in women than in men. The mean age of incidence was 20 to 60 years old.Surgical trends have been directed toward less invasive procedures, especially since the establishment of laparoscopic cholecystectomy. Endoscopic procedures are being applied in various fields because they produce less pain and better cosmetic results.Thyroidectomy is a procedure that can be safely performed in most clinical settings and therefore it is difficult to define why one should perform it by a minimally invasive approach and which advantages one should expect from these techniques. However, a minimally invasive approach should guarantee better cosmetic results. This is particularly true when dealing with small nodules, which would have to be retrieved by traditional cervicotomy, leaving an unnecessarily large scar. This is very important because the majority of patients are young women, for whom the esthetic appearance is very important. Furthermore the minimally invasive approach should also provide a better postoperative course, reducing postoperative pain and discomfort.This study was carried on twenty patients with solitary thyroid nodule who were admitted to the general surgery department, Zagazig university hospital, during the period from September 2004 to august 2005. to assess the video-assisted endoscopy as a new technique in management of solitary thyroid nodule, and to compare it with conventional thyroidectomy. The patients were 16 females and 4 males. Their ages range between 18 and 45 years with a mean age of 26 years. 8 patients were treated with assisted endoscopic thyroidectomy (7 females and a male), the other 12 patients were treated with conventional thyroidectomy (9 females and 3 males).The challenge of the video-assisted approach is to be able to perform a thyroid lobectomy (or a total thyroidectomy) in a minimally invasive way, using the same technique as for conventional surgery to guarantee safe control of the vascular pedicles and to localize and avoid damage to the parathyroid glands and recurrent laryngeal nerve.All the patients have been subjected to the following preoperative assessment : full history sheet was taken from each case, general examination, local examination of the neck region, indirect laryngoscopy for evaluation of vocal cords mobility, laboratory investigation in the form of routine investigation (as, complete blood picture, liver function tests, kidney function tests, PT, PTT and ESR), serum T3, T4 and TSH, neck ultrasound, FNAC of the thyroid nodule with sonar guided and thyroid scanning (Tcm99) for selected cases.The patients were divided to two groups:Group I (n = 12) were submitted for conventional thyroidectomy.Group II (n = 8) were submitted for video-assisted endoscopic thyroidectomy.In Conclusion, Minimally invasive video-assisted thyroid surgery is an innovative, attractive, and promising approach for the surgical treatment of small thyroid lesions. The procedure is safe, requiring only simple instrumentation, but it also requires a precise and gentle surgical technique that follows the same surgical rules as the classical approach. This technique yields excellent results in terms of cosmoses and the postoperative patient comfort.Although larger series of patients will be necessary before deciding to introduce minimally invasive thyroid surgery in selected centers. It can be concluded that MIVAT is a safe procedure offering some advantages to patients who, at present, still represent only a minority whom undergo thyroid surgery.SUMMARY AND CONCLUSIONThe solitary thyroid nodule is defined as a single discrete mass in an otherwise impalpable gland, whereas the preferred term for a similar swelling in a gland with clinical evidence of generalized abnormality in the form of a palpable contra-lateral lobe or generalized mild nodularity is “dominant”.Solitary thyroid nodules present in approximately 4 percent of individuals, however single nodules are about four times more common in women than in men. The mean age of incidence was 20 to 60 years old.Surgical trends have been directed toward less invasive procedures, especially since the establishment of laparoscopic cholecystectomy. Endoscopic procedures are being applied in various fields because they produce less pain and better cosmetic results.Thyroidectomy is a procedure that can be safely performed in most clinical settings and therefore it is difficult to define why one should perform it by a minimally invasive approach and which advantages one should expect from these techniques. However, a minimally invasive approach should guarantee better cosmetic results. This is particularly true when dealing with small nodules, which would have to be retrieved by traditional cervicotomy, leaving an unnecessarily large scar. This is very important because the majority of patients are young women, for whom the esthetic appearance is very important. Furthermore the minimally invasive approach should also provide a better postoperative course, reducing postoperative pain and discomfort.This study was carried on twenty patients with solitary thyroid nodule who were admitted to the general surgery department, Zagazig university hospital, during the period from September 2004 to august 2005. to assess the video-assisted endoscopy as a new technique in management of solitary thyroid nodule, and to compare it with conventional thyroidectomy. The patients were 16 females and 4 males. Their ages range between 18 and 45 years with a mean age of 26 years. 8 patients were treated with assisted endoscopic thyroidectomy (7 females and a male), the other 12 patients were treated with conventional thyroidectomy (9 females and 3 males).The challenge of the video-assisted approach is to be able to perform a thyroid lobectomy (or a total thyroidectomy) in a minimally invasive way, using the same technique as for conventional surgery to guarantee safe control of the vascular pedicles and to localize and avoid damage to the parathyroid glands and recurrent laryngeal nerve.All the patients have been subjected to the following preoperative assessment : full history sheet was taken from each case, general examination, local examination of the neck region, indirect laryngoscopy for evaluation of vocal cords mobility, laboratory investigation in the form of routine investigation (as, complete blood picture, liver function tests, kidney function tests, PT, PTT and ESR), serum T3, T4 and TSH, neck ultrasound, FNAC of the thyroid nodule with sonar guided and thyroid scanning (Tcm99) for selected cases.The patients were divided to two groups:Group I (n = 12) were submitted for conventional thyroidectomy.Group II (n = 8) were submitted for video-assisted endoscopic thyroidectomy.In Conclusion, Minimally invasive video-assisted thyroid surgery is an innovative, attractive, and promising approach for the surgical treatment of small thyroid lesions. The procedure is safe, requiring only simple instrumentation, but it also requires a precise and gentle surgical technique that follows the same surgical rules as the classical approach. This technique yields excellent results in terms of cosmoses and the postoperative patient comfort.Although larger series of patients will be necessary before deciding to introduce minimally invasive thyroid surgery in selected centers. It can be concluded that MIVAT is a safe procedure offering some advantages to patients who, at present, still represent only a minority whom undergo thyroid surgery.SUMMARY AND CONCLUSIONThe solitary thyroid nodule is defined as a single discrete mass in an otherwise impalpable gland, whereas the preferred term for a similar swelling in a gland with clinical evidence of generalized abnormality in the form of a palpable contra-lateral lobe or generalized mild nodularity is “dominant”.Solitary thyroid nodules present in approximately 4 percent of individuals, however single nodules are about four times more common in women than in men. The mean age of incidence was 20 to 60 years old.Surgical trends have been directed toward less invasive procedures, especially since the establishment of laparoscopic cholecystectomy. Endoscopic procedures are being applied in various fields because they produce less pain and better cosmetic results.Thyroidectomy is a procedure that can be safely performed in most clinical settings and therefore it is difficult to define why one should perform it by a minimally invasive approach and which advantages one should expect from these techniques. However, a minimally invasive approach should guarantee better cosmetic results. This is particularly true when dealing with small nodules, which would have to be retrieved by traditional cervicotomy, leaving an unnecessarily large scar. This is very important because the majority of patients are young women, for whom the esthetic appearance is very important. Furthermore the minimally invasive approach should also provide a better postoperative course, reducing postoperative pain and discomfort.This study was carried on twenty patients with solitary thyroid nodule who were admitted to the general surgery department, Zagazig university hospital, during the period from September 2004 to august 2005. to assess the video-assisted endoscopy as a new technique in management of solitary thyroid nodule, and to compare it with conventional thyroidectomy. The patients were 16 females and 4 males. Their ages range between 18 and 45 years with a mean age of 26 years. 8 patients were treated with assisted endoscopic thyroidectomy (7 females and a male), the other 12 patients were treated with conventional thyroidectomy (9 females and 3 males).The challenge of the video-assisted approach is to be able to perform a thyroid lobectomy (or a total thyroidectomy) in a minimally invasive way, using the same technique as for conventional surgery to guarantee safe control of the vascular pedicles and to localize and avoid damage to the parathyroid glands and recurrent laryngeal nerve.All the patients have been subjected to the following preoperative assessment : full history sheet was taken from each case, general examination, local examination of the neck region, indirect laryngoscopy for evaluation of vocal cords mobility, laboratory investigation in the form of routine investigation (as, complete blood picture, liver function tests, kidney function tests, PT, PTT and ESR), serum T3, T4 and TSH, neck ultrasound, FNAC of the thyroid nodule with sonar guided and thyroid scanning (Tcm99) for selected cases.The patients were divided to two groups:Group I (n = 12) were submitted for conventional thyroidectomy.Group II (n = 8) were submitted for video-assisted endoscopic thyroidectomy.In Conclusion, Minimally invasive video-assisted thyroid surgery is an innovative, attractive, and promising approach for the surgical treatment of small thyroid lesions. The procedure is safe, requiring only simple instrumentation, but it also requires a precise and gentle surgical technique that follows the same surgical rules as the classical approach. This technique yields excellent results in terms of cosmoses and the postoperative patient comfort.Although larger series of patients will be necessary before deciding to introduce minimally invasive thyroid surgery in selected centers. It can be concluded that MIVAT is a safe procedure offering some advantages to patients who, at present, still represent only a minority whom undergo thyroid surgery.SUMMARY AND CONCLUSIONThe solitary thyroid nodule is defined as a single discrete mass in an otherwise impalpable gland, whereas the preferred term for a similar swelling in a gland with clinical evidence of generalized abnormality in the form of a palpable contra-lateral lobe or generalized mild nodularity is “dominant”.Solitary thyroid nodules present in approximately 4 percent of individuals, however single nodules are about four times more common in women than in men. The mean age of incidence was 20 to 60 years old.Surgical trends have been directed toward less invasive procedures, especially since the establishment of laparoscopic cholecystectomy. Endoscopic procedures are being applied in various fields because they produce less pain and better cosmetic results.Thyroidectomy is a procedure that can be safely performed in most clinical settings and therefore it is difficult to define why one should perform it by a minimally invasive approach and which advantages one should expect from these techniques. However, a minimally invasive approach should guarantee better cosmetic results. This is particularly true when dealing with small nodules, which would have to be retrieved by traditional cervicotomy, leaving an unnecessarily large scar. This is very important because the majority of patients are young women, for whom the esthetic appearance is very important. Furthermore the minimally invasive approach should also provide a better postoperative course, reducing postoperative pain and discomfort.This study was carried on twenty patients with solitary thyroid nodule who were admitted to the general surgery department, Zagazig university hospital, during the period from September 2004 to august 2005. to assess the video-assisted endoscopy as a new technique in management of solitary thyroid nodule, and to compare it with conventional thyroidectomy. The patients were 16 females and 4 males. Their ages range between 18 and 45 years with a mean age of 26 years. 8 patients were treated with assisted endoscopic thyroidectomy (7 females and a male), the other 12 patients were treated with conventional thyroidectomy (9 females and 3 males).The challenge of the video-assisted approach is to be able to perform a thyroid lobectomy (or a total thyroidectomy) in a minimally invasive way, using the same technique as for conventional surgery to guarantee safe control of the vascular pedicles and to localize and avoid damage to the parathyroid glands and recurrent laryngeal nerve.All the patients have been subjected to the following preoperative assessment : full history sheet was taken from each case, general examination, local examination of the neck region, indirect laryngoscopy for evaluation of vocal cords mobility, laboratory investigation in the form of routine investigation (as, complete blood picture, liver function tests, kidney function tests, PT, PTT and ESR), serum T3, T4 and TSH, neck ultrasound, FNAC of the thyroid nodule with sonar guided and thyroid scanning (Tcm99) for selected cases.The patients were divided to two groups:Group I (n = 12) were submitted for conventional thyroidectomy.Group II (n = 8) were submitted for video-assisted endoscopic thyroidectomy.In Conclusion, Minimally invasive video-assisted thyroid surgery is an innovative, attractive, and promising approach for the surgical treatment of small thyroid lesions. The procedure is safe, requiring only simple instrumentation, but it also requires a precise and gentle surgical technique that follows the same surgical rules as the classical approach. This technique yields excellent results in terms of cosmoses and the postoperative patient comfort.Although larger series of patients will be necessary before deciding to introduce minimally invasive thyroid surgery in selected centers. It can be concluded that MIVAT is a safe procedure offering some advantages to patients who, at present, still represent only a minority whom undergo thyroid surgery.SUMMARY AND CONCLUSIONThe solitary thyroid nodule is defined as a single discrete mass in an otherwise impalpable gland, whereas the preferred term for a similar swelling in a gland with clinical evidence of generalized abnormality in the form of a palpable contra-lateral lobe or generalized mild nodularity is “dominant”.Solitary thyroid nodules present in approximately 4 percent of individuals, however single nodules are about four times more common in women than in men. The mean age of incidence was 20 to 60 years old.Surgical trends have been directed toward less invasive procedures, especially since the establishment of laparoscopic cholecystectomy. Endoscopic procedures are being applied in various fields because they produce less pain and better cosmetic results.Thyroidectomy is a procedure that can be safely performed in most clinical settings and therefore it is difficult to define why one should perform it by a minimally invasive approach and which advantages one should expect from these techniques. However, a minimally invasive approach should guarantee better cosmetic results. This is particularly true when dealing with small nodules, which would have to be retrieved by traditional cervicotomy, leaving an unnecessarily large scar. This is very important because the majority of patients are young women, for whom the esthetic appearance is very important. Furthermore the minimally invasive approach should also provide a better postoperative course, reducing postoperative pain and discomfort.This study was carried on twenty patients with solitary thyroid nodule who were admitted to the general surgery department, Zagazig university hospital, during the period from September 2004 to august 2005. to assess the video-assisted endoscopy as a new technique in management of solitary thyroid nodule, and to compare it with conventional thyroidectomy. The patients were 16 females and 4 males. Their ages range between 18 and 45 years with a mean age of 26 years. 8 patients were treated with assisted endoscopic thyroidectomy (7 females and a male), the other 12 patients were treated with conventional thyroidectomy (9 females and 3 males).The challenge of the video-assisted approach is to be able to perform a thyroid lobectomy (or a total thyroidectomy) in a minimally invasive way, using the same technique as for conventional surgery to guarantee safe control of the vascular pedicles and to localize and avoid damage to the parathyroid glands and recurrent laryngeal nerve.All the patients have been subjected to the following preoperative assessment : full history sheet was taken from each case, general examination, local examination of the neck region, indirect laryngoscopy for evaluation of vocal cords mobility, laboratory investigation in the form of routine investigation (as, complete blood picture, liver function tests, kidney function tests, PT, PTT and ESR), serum T3, T4 and TSH, neck ultrasound, FNAC of the thyroid nodule with sonar guided and thyroid scanning (Tcm99) for selected cases.The patients were divided to two groups:Group I (n = 12) were submitted for conventional thyroidectomy.Group II (n = 8) were submitted for video-assisted endoscopic thyroidectomy.In Conclusion, Minimally invasive video-assisted thyroid surgery is an innovative, attractive, and promising approach for the surgical treatment of small thyroid lesions. The procedure is safe, requiring only simple instrumentation, but it also requires a precise and gentle surgical technique that follows the same surgical rules as the classical approach. This technique yields excellent results in terms of cosmoses and the postoperative patient comfort.Although larger series of patients will be necessary before deciding to introduce minimally invasive thyroid surgery in selected centers. It can be concluded that MIVAT is a safe procedure offering some advantages to patients who, at present, still represent only a minority whom undergo thyroid surgery.SUMMARY AND CONCLUSIONThe solitary thyroid nodule is defined as a single discrete mass in an otherwise impalpable gland, whereas the preferred term for a similar swelling in a gland with clinical evidence of generalized abnormality in the form of a palpable contra-lateral lobe or generalized mild nodularity is “dominant”.Solitary thyroid nodules present in approximately 4 percent of individuals, however single nodules are about four times more common in women than in men. The mean age of incidence was 20 to 60 years old.Surgical trends have been directed toward less invasive procedures, especially since the establishment of laparoscopic cholecystectomy. Endoscopic procedures are being applied in various fields because they produce less pain and better cosmetic results.Thyroidectomy is a procedure that can be safely performed in most clinical settings and therefore it is difficult to define why one should perform it by a minimally invasive approach and which advantages one should expect from these techniques. However, a minimally invasive approach should guarantee better cosmetic results. This is particularly true when dealing with small nodules, which would have to be retrieved by traditional cervicotomy, leaving an unnecessarily large scar. This is very important because the majority of patients are young women, for whom the esthetic appearance is very important. Furthermore the minimally invasive approach should also provide a better postoperative course, reducing postoperative pain and discomfort.This study was carried on twenty patients with solitary thyroid nodule who were admitted to the general surgery department, Zagazig university hospital, during the period from September 2004 to august 2005. to assess the video-assisted endoscopy as a new technique in management of solitary thyroid nodule, and to compare it with conventional thyroidectomy. The patients were 16 females and 4 males. Their ages range between 18 and 45 years with a mean age of 26 years. 8 patients were treated with assisted endoscopic thyroidectomy (7 females and a male), the other 12 patients were treated with conventional thyroidectomy (9 females and 3 males).The challenge of the video-assisted approach is to be able to perform a thyroid lobectomy (or a total thyroidectomy) in a minimally invasive way, using the same technique as for conventional surgery to guarantee safe control of the vascular pedicles and to localize and avoid damage to the parathyroid glands and recurrent laryngeal nerve.All the patients have been subjected to the following preoperative assessment : full history sheet was taken from each case, general examination, local examination of the neck region, indirect laryngoscopy for evaluation of vocal cords mobility, laboratory investigation in the form of routine investigation (as, complete blood picture, liver function tests, kidney function tests, PT, PTT and ESR), serum T3, T4 and TSH, neck ultrasound, FNAC of the thyroid nodule with sonar guided and thyroid scanning (Tcm99) for selected cases.The patients were divided to two groups:Group I (n = 12) were submitted for conventional thyroidectomy.Group II (n = 8) were submitted for video-assisted endoscopic thyroidectomy.In Conclusion, Minimally invasive video-assisted thyroid surgery is an innovative, attractive, and promising approach for the surgical treatment of small thyroid lesions. The procedure is safe, requiring only simple instrumentation, but it also requires a precise and gentle surgical technique that follows the same surgical rules as the classical approach. This technique yields excellent results in terms of cosmoses and the postoperative patient comfort.Although larger series of patients will be necessary before deciding to introduce minimally invasive thyroid surgery in selected centers. It can be concluded that MIVAT is a safe procedure offering some advantages to patients who, at present, still represent only a minority whom undergo thyroid surgery.SUMMARY AND CONCLUSIONThe solitary thyroid nodule is defined as a single discrete mass in an otherwise impalpable gland, whereas the preferred term for a similar swelling in a gland with clinical evidence of generalized abnormality in the form of a palpable contra-lateral lobe or generalized mild nodularity is “dominant”.Solitary thyroid nodules present in approximately 4 percent of individuals, however single nodules are about four times more common in women than in men. The mean age of incidence was 20 to 60 years old.Surgical trends have been directed toward less invasive procedures, especially since the establishment of laparoscopic cholecystectomy. Endoscopic procedures are being applied in various fields because they produce less pain and better cosmetic results.Thyroidectomy is a procedure that can be safely performed in most clinical settings and therefore it is difficult to define why one should perform it by a minimally invasive approach and which advantages one should expect from these techniques. However, a minimally invasive approach should guarantee better cosmetic results. This is particularly true when dealing with small nodules, which would have to be retrieved by traditional cervicotomy, leaving an unnecessarily large scar. This is very important because the majority of patients are young women, for whom the esthetic appearance is very important. Furthermore the minimally invasive approach should also provide a better postoperative course, reducing postoperative pain and discomfort.This study was carried on twenty patients with solitary thyroid nodule who were admitted to the general surgery department, Zagazig university hospital, during the period from September 2004 to august 2005. to assess the video-assisted endoscopy as a new technique in management of solitary thyroid nodule, and to compare it with conventional thyroidectomy. The patients were 16 females and 4 males. Their ages range between 18 and 45 years with a mean age of 26 years. 8 patients were treated with assisted endoscopic thyroidectomy (7 females and a male), the other 12 patients were treated with conventional thyroidectomy (9 females and 3 males).The challenge of the video-assisted approach is to be able to perform a thyroid lobectomy (or a total thyroidectomy) in a minimally invasive way, using the same technique as for conventional surgery to guarantee safe control of the vascular pedicles and to localize and avoid damage to the parathyroid glands and recurrent laryngeal nerve.All the patients have been subjected to the following preoperative assessment : full history sheet was taken from each case, general examination, local examination of the neck region, indirect laryngoscopy for evaluation of vocal cords mobility, laboratory investigation in the form of routine investigation (as, complete blood picture, liver function tests, kidney function tests, PT, PTT and ESR), serum T3, T4 and TSH, neck ultrasound, FNAC of the thyroid nodule with sonar guided and thyroid scanning (Tcm99) for selected cases.The patients were divided to two groups:Group I (n = 12) were submitted for conventional thyroidectomy.Group II (n = 8) were submitted for video-assisted endoscopic thyroidectomy.In Conclusion, Minimally invasive video-assisted thyroid surgery is an innovative, attractive, and promising approach for the surgical treatment of small thyroid lesions. The procedure is safe, requiring only simple instrumentation, but it also requires a precise and gentle surgical technique that follows the same surgical rules as the classical approach. This technique yields excellent results in terms of cosmoses and the postoperative patient comfort.Although larger series of patients will be necessary before deciding to introduce minimally invasive thyroid surgery in selected centers. It can be concluded that MIVAT is a safe procedure offering some advantages to patients who, at present, still represent only a minority whom undergo thyroid surgery.SUMMARY AND CONCLUSIONThe solitary thyroid nodule is defined as a single discrete mass in an otherwise impalpable gland, whereas the preferred term for a similar swelling in a gland with clinical evidence of generalized abnormality in the form of a palpable contra-lateral lobe or generalized mild nodularity is “dominant”.Solitary thyroid nodules present in approximately 4 percent of individuals, however single nodules are about four times more common in women than in men. The mean age of incidence was 20 to 60 years old.Surgical trends have been directed toward less invasive procedures, especially since the establishment of laparoscopic cholecystectomy. Endoscopic procedures are being applied in various fields because they produce less pain and better cosmetic results.Thyroidectomy is a procedure that can be safely performed in most clinical settings and therefore it is difficult to define why one should perform it by a minimally invasive approach and which advantages one should expect from these techniques. However, a minimally invasive approach should guarantee better cosmetic results. This is particularly true when dealing with small nodules, which would have to be retrieved by traditional cervicotomy, leaving an unnecessarily large scar. This is very important because the majority of patients are young women, for whom the esthetic appearance is very important. Furthermore the minimally invasive approach should also provide a better postoperative course, reducing postoperative pain and discomfort.This study was carried on twenty patients with solitary thyroid nodule who were admitted to the general surgery department, Zagazig university hospital, during the period from September 2004 to august 2005. to assess the video-assisted endoscopy as a new technique in management of solitary thyroid nodule, and to compare it with conventional thyroidectomy. The patients were 16 females and 4 males. Their ages range between 18 and 45 years with a mean age of 26 years. 8 patients were treated with assisted endoscopic thyroidectomy (7 females and a male), the other 12 patients were treated with conventional thyroidectomy (9 females and 3 males).The sexual precocity is the appearance of any sign of secondary sexual maturation before the age of nine years in boys. Precocity due to early activation of the pulse generation of hypothalamic GnRH is known as central or GnRH dependant precocious puberty.On the other hand GnRH independent precocious puberty is due to a heterogeneous group of disorders which includes tumors that secret HCG and testicular or adrenal tumors that produce testosterone.We should interfere before the age of 9 years if there is any manifestation of precocity.In GnRH dependant precocious puberty, either organic causes as craniopharyngoma tumor which lies in Rathk’s pouch and secret LHRH and which leads to infertility and short stature should be excluded and surgically removed or functional causes.In this type of precocity give GnRH in constant manner to suppress HPG axis (e.g. leuporlide acetate and nafrelin acetate).In GnRH independent precocious puberty give steroid synthetase inhibitor (e.g. ketokonazole), antiandrogen (e.g. sprinolactone) and aromatase inhibitors (e.g. testolactone).In boys, absence of testicular enlargement by 14 years of age (volume < 4cc) defines as delayed puberty. In addition, delayed sexual development in boys is also defined as, slow progression of development or the passage of five years between the initial and the complete development of the genitalia. Delayed puberty is due to either hypogonadotropic hypogonadism (secondary), hypergonadotropic hypogonadism (primary) or Constitutional Growth Delay.In hypogonadotropic hypogonadism, Kallmann’s syndrome is the most common cause of isolated gonadotropin deficiency (hypogonadism with anosmia). Craniopharingoma the most common neoplasm in the hypothalamus pituitary area should be excluded early as it leads to either GnRH or gonadotropin deficiency. Early eradication of the tumor leads to satisfactory results.In hyperogonadotropic hypogonadism, the most common cause of gonadal failure is Klinefelter syndrome should be excluded clinically and by karyotyping. Sertoli cell only syndrome should be in mind. The diagnosis is mainly by testicular biopsy. Chronic illness and drug abuse should be asked in the history. Treatment of these disorders is still of guarded prognosis and ill satisfactory benefit to these patients.The most common cause of delayed puberty is constitutional delay of growth and maturation, which affect 53% of subjects of delayed puberty. Could be treated by sex steroid, short stature could be corrected especially in boys between 10-14 years and delayed puberty after age of 14 years old.However, early diagnosis and early proper interference in many cases cause better results with new advanced investigations and treatment.