Minimally invasive video-assisted thyroidectomy can be done in all except

Minimally invasive video-assisted thyroidectomy involves the use of a 1.5- to 2-cm anterior cervical incision, an endoscopic camera placed into the wound for visualization, self-retaining retractors, and dedicated surgical instruments. This technique is most commonly applied to lobectomy for benign disease, but it has been applied to total thyroidectomy including for malignancy. Prior neck surgery, a large-volume thyroid (>25 mL), a large lesion, and lymphatic metastasis are considered contraindications to this technique.