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September 2013

Less Is More: The Example of Minimally Invasive Thyroidectomy

Author Affiliations
  • 1Department of Surgery, Athens Medical School, Marousi, Greece
  • 2and member of the International Advisory Board JAMA Surgery
JAMA Surg. 2013;148(9):808-809. doi:10.1001/jamasurg.2013.2263

The editors of JAMA Internal Medicine recently raised the question about whether more of certain health care activities can sometimes result in poorer health outcomes.1 Although the list of examples is growing in the medical literature, this important issue geared toward improving patient care has not been adequately discussed for several surgical therapies.

We propose that minimally invasive thyroidectomy (MIT) is one example within surgery where new, and more complex, technologies may not offer additional benefits above traditional ones. The goal of MIT is to remove the thyroid with a smaller scar. However, this procedure may be a misnomer because there is nothing “minimal” about the additional cost, training, complexity, and risk involved. Unlike the established benefits of laparoscopic abdominal surgery, it is unclear whether MIT offers any advantages to the patient as compared with standard thyroidectomy.