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 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.4- Number of nocturnal asthmatic attacks.The specific injectable immunotherapy (SIT) was given to active group patients in this study by stepwise subcutaneouse injection of increasing concentrations of allergen to which the patients is sensitive twice weekly, starting by a concentration of 1/2000 aqueous solution of allergenic extract then 1/1000, then 1/500, then 1/250 then 1/125.Once the patients reached their full or ’maintenance’ concentration of 1/100 they were maintained on the maximally tolerated dose of concentration for 6 months.Immunotherapy was administered according to preseasonal schedule 6 months before the pollen season. The patients maintained on the maintenance dose until beginning of the pollen season then immunotherapy was stopped (Rapiejko and Ligezinski, 1997).The patients were evaluated before, after and between injections to register the patient’s condition and any immediate (15 min.) and late (6 hours) reaction to allergen injected.The control group was not given SIT and continued their medical treatment.The patients were evaluated for 6 months by:1- Clinical evaluation by symptom and medication scores before and after SIT by score 0-3.2- Immunologic evaluation before and after SIT by:a) Total serum IgE.b) Total serum IgG.Our results were tabulated, subjected to statistical analysis and following conclusions were reached:• Significant improvement in symptom and medication scores were observed after SIT in all patients.• Significant decrease in serum IgE level after SIT in all patients.• Significant increase in serum IgG level after SIT in all patients.• So, SIT is considered as a line of treatment for allergic patients with daily pharmacotherapy in asthma and allergic rhinitis.REFERENCESAdamko D, Odemuyiwa SO, Moqbel R. 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Clin Sci (Lond) 2005; 108(6): 463-77.Barbee RA, Lebowitz MD, Thompson HC, Burrows B. Immediate skin-test reactivity in a general population sample. Ann Intern Med 1976; 84(2): 129-33.Barnes PJ, Chung KF, Page CP. Inflammatory mediators of asthma: an