Minimally Invasive Video-Assisted Thyroidectomy (MIVAT)

Advanced Thyroid Surgery with Less Scarring

If you’re diagnosed with thyroid cancer, you want treatment that’s effective — and as easy on your body as possible. At the Providence Swedish Cancer Institute, our expert surgeons use minimally invasive video-assisted thyroidectomy (MIVAT) to remove the thyroid through a small incision, helping reduce tissue damage, limit scarring, and support a faster recovery.

Treatment Overview

MIVAT uses a small, flexible tube called an endoscope. At the tip is a camera that sends high-resolution images to a screen, giving your surgeon a magnified view of your thyroid and the tissue around it.

Although MIVAT is often an outpatient procedure, you’ll be under general anesthesia. Once it’s taken effect, your surgeon will make a small incision — less than an inch long — in the lower front part of your neck and insert the endoscope. Special instruments will pass through the endoscope to remove part or all of your thyroid. Once the procedure is finished, you’ll remain in the recovery room as you wake up from anesthesia.

Unlike traditional thyroid surgery, which requires a larger incision and more tissue disruption, MIVAT gives your surgeon direct access to your thyroid with less impact on surrounding tissue, often resulting in a smaller scar and faster recovery.

What to Expect

At the Providence Swedish Cancer Institute, we’ll guide you through the planning stages of the MIVAT through to discharge, recovery, and future treatment if needed. Your care team is here to support your physical healing, emotional well-being, and personal goals, so you can move forward with confidence.

About a week before your surgery, we’ll contact you to:

Assist with remaining pre-surgical lab work or tests
Review what will happen during your surgery
Explain potential side effects
Discuss medications and post-surgery care, and answer any questions you may have

You'll receive information to prepare for your hospital admission if necessary. If you have any questions after this appointment, you can reach out to your nurse or care coordinator, who will be happy to help.

Many patients go home the same day as their surgery, though in some cases, you may need to stay overnight. You’ll need a responsible adult to drive you home.

If your entire thyroid was removed, your doctor will prescribe thyroid hormone replacement. Your care team will also advise you on managing throat or neck pain, any medications to take, and what to avoid during recovery, such as heavy lifting. Most people can return to their usual activities within 2 to 3 weeks.

MIVAT has many benefits over traditional thyroid surgery. You’ll have less scarring because of the much smaller incision, as well as less pain, swelling, and time in the hospital if you are admitted. People who have had MIVAT seem to get their voice back faster – there’s a lower risk of impact to vocal cords – and patients often regain their swallowing function quicker. All these advantages may result in a faster return to your regular activities.

As with any surgery, there are risks, including:

Infection
Bleeding
Hoarseness or loss of your voice
Injury to the trachea (windpipe)

Your care team will talk with you about these risks, answer your questions, and help you make an informed decision that aligns with your goals.

Your care team is here to support you after your surgery. You may have some appointments for the first few weeks to help us monitor your healing and manage any complications. Regular checkups are still important so we can continue to manage any of your ongoing treatment needs and watch for signs of recurrence.

Services are also available to help you through every treatment stage. Learn more about our supportive care services.

Frequently Asked Questions

Your surgeon may recommend MIVAT if your thyroid gland isn’t too large — typically 3.5 inches or less. In some cases, MIVAT is still possible even if cancer has spread to nearby lymph nodes, as long as the spread isn’t extensive and remains within the thyroid.

You may not be a candidate if you have thyroiditis (inflammation of the thyroid) or if you’ve had previous neck surgery or radiation to the neck area.

Not everyone who has thyroid cancer can have MIVAT. Other options might be better suited for you, such as traditional thyroid surgery or radioactive iodine therapy that kills certain types of cancer cells. If you aren’t a candidate for MIVAT, your surgeon will go over your options, and together, you’ll choose the most appropriate treatment for your particular diagnosis.

MIVAT is minimally invasive, but it is still surgery, and sometimes a hospital stay is needed. Some patients are admitted to the hospital the night before, especially if they need closer monitoring before surgery. Some patients are admitted after MIVAT due to nausea or vomiting from the general anesthesia, complications from the surgery itself, or the need for follow-up care.

Your care team will contact you before your procedure to explain the process and schedule any necessary pre-surgery tests. These typically include blood work, thyroid function tests, and an ultrasound of your thyroid. If you take medications, you'll be told which ones to stop taking and when. You’ll also be asked to fast — meaning no food or drink — for several hours before surgery. If you smoke, your care team will recommend quitting as early as possible to support your recovery.

Your doctor will talk to you about any medications you need after surgery. If all or a large portion of your thyroid is removed, you’ll likely need to take thyroid replacement medication to maintain hormone levels. It can take several weeks to adjust the dose until it’s right for your body. Some patients are also advised to take calcium supplements after surgery, depending on how much of the thyroid was removed and how their body responds during recovery.

Complications from MIVAT are much less common than with traditional thyroid surgery. They may include infection, bleeding, hematomas (the collection of blood causing a lump under your skin), and temporary hoarseness. Your surgeon will go over any potential risks with you and answer your questions before the procedure.