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Brunaud et al¹ are to be commended for their attempt to numerically define an elusive term. They propose that the term minimally invasive be used to describe only thyroid procedures that are routinely associated with an incision shorter than 3 cm. This arbitrary threshold was apparently based on their observation that the shortest length of incisions in their current series of open conventional lobectomies was 3 cm (mean, 4.6 cm). Coincidentally, 1 month earlier I published results of an open hemithyroidectomy series with a similar mean incision length of 4.7 cm (shortest measurement, 2.7cm).² In my case, minimally invasive thyroidectomy would have meant procedures performed through a wound shorter than 2.7 cm.

Surgical trauma, particularly in neck operations, is determined not only by the incision size but also by incision location and the target organ to be removed. Sackett et al³ (under L. W. Delbridge, MD, Department of Surgery, University . . . [Full Text of this Article]

Jacob W. T. Ng, FRCS