Minimally invasive and remote access surgery for the thyroid and parathyroid glands has evolved over the last two decades. The emphasis of minimally invasive surgery is limiting the amount of tissue dissection while achieving the same surgical results. Alternatively, the emphasis of remote access surgery is to achieve better cosmetic results by avoiding a cervical scar. Therefore, although minimally invasive surgery and remote access surgery may use similar tools, they ultimately provide different advantages and drawbacks. The concept of minimally invasive parathyroidectomy (MIP) has been widely embraced, but includes a variety of operations, and the term may be confusing. The techniques of minimally invasive thyroidectomy (MIT) have been less universally adopted. MIP and MIT encompass an assortment of procedures ranging from simply shortening the cervical incision to using the endoscope and robot. In this chapter we review the evolution of the concepts, principles, and techniques of MIP, MIT, and remote access surgery for the thyroid and parathyroid glands with the intent of giving surgeons a framework to understand these diverse and frequently misunderstood operations.
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