Aim: We aimed to test the hypothesis that the minimally invasive video-assisted thyroidectomy (MIVAT) 
affords comparable safety and efficacy as to the open conventional surgery in patients with unilateral 
thyroid nodules or follicular lesions in terms of cosmetic results, intraoperative and postoperative
complications, postoperative pain, and hospital stay.
Methods: This was a single-blinded randomized controlled trial comparing the MIVAT with conventional 
thyroidectomy. The primary endpoints of the study were measurement of postoperative pain after 24 and 48 
hours from operation and cosmetic outcome 3 months postoperatively. The secondary outcome measures 
were operative time, incidence of recurrent laryngeal nerve injury, length of incision, and hospital stay.
Results: Operative time was less with open thyroidectomy than with MIVAT, while MIVAT was associated 
with less pain 24 hours postoperatively. Pain score depicted statistically significant differences in favor of 
the MIVAT after 24 hours. MIVAT was associated with less scarring and more satisfaction with cosmetic 
results. There was no difference between both procedures for presence of transient recurrent laryngeal nerve 
palsy and hypoparathyroidism.
Conclusion: MIVAT is a safe procedure that produces outcomes similar to those of open thyroidectomy, 
and is superior in terms of immediate postoperative pain and cosmetic results.