Until the past decade, there have been no significant advances in the surgical technique of thyroidectomy established early in the last century. The advent of energized dissecting and cutting instruments, most notably the Harmonic scalpel, relieved the surgeon of the necessity of clamping and tying vessels. This facilitated the contemplation of minimization and relocation of incisions distant from the neck. Combined with advances in laparoscopic surgical instrumentation and techniques, which occurred in the 1990s, the stage was set for the field of minimally invasive surgery (MIS) of the thyroid gland to develop.