# Use of technologies in thyroid surgery: Latin American Thyroid Society Surgical Affairs Committee Expert Opinion. Part 1

## TL;DR

This paper reviews advanced technologies in thyroid surgery and their impact on outcomes, focusing on accessibility and cost in Latin America.

## Contribution

The paper provides expert guidance on the use of emerging thyroid surgery technologies in Latin America.

## Key findings

- Technologies like vessel sealing and IONM improve surgical outcomes and reduce complications.
- Remote access surgery offers comparable results to open thyroidectomy but takes longer.
- Fluorescence improves parathyroid detection and reduces hypoparathyroidism risk.

## Abstract

Thyroidectomyis the most frequent endocrine surgical treatment for problems such
as goiter, thyroid cancer, and Graves’ disease. The global incidence of goiter
ranges from 5%-20%, with a notably high frequency in less wealthy countries, and
the incidence of thyroid cancer is on the rise due to the greater use of
diagnostic imaging. Despite medical options, surgery remains essential. Surgical
advancements such as blood vessel sealing technology, intraoperative laryngeal
nerve neuromonitoring (IONM), remote access surgery, and parathyroid
fluorescence have transformed thyroid surgery. Vessel sealing technologies
reduce operative time and blood loss, whereas IONM preserves the laryngeal
nerves. Remote access surgery, which includes a variety of techniques, produces
results similar to those of open thyroidectomy with a longer operative time.
Fluorescence enhances parathyroid detection and lowers the risk of temporary
hypoparathyroidism. Economic studies reveal cost discrepancies, with advantages
particularly visible in health care systems that depend on surgical time. While
these advancements promise better patient outcomes, their accessibility and
cost-effectiveness remain issues, particularly in Latin America. Recognizing
these concerns, the Latin American Thyroid Society’s Surgical Affairs Committee
conducted an extensive review of emerging thyroid surgery technologies to
guarantee their proper use in the area.