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Minimally invasive video-assisted technique (MIVAT) was initially described by Miccoli and colleagues in Italy. The MIVAT without gas infusion was introduced in the clinical practice to treat small benign thyroid nodules and had advantages in terms of cosmetic results compared with the conventional approach.To compare the outcome in papillary thyroid microcarcinoma (PTMC) patients treated with MIVAT and conventional procedure, and evaluate the feasibility of MIVAT applied in PTMC patients.Data of 35 PTMC patients with MIVAT and 33 others with conventional procedure were analyzed and compared, including postoperative outcomes, operative time, incidence of complications, the completeness of operation, and the prognosis of tumor after a follow-up of 5 years.With regard to the postoperative outcomes, a significantly statistical difference was found between MIVAT group and the conventional procedure group. The mean operative time in the MIVAT group was longer than that in the conventional group. However, it was similar to the convention group when only the mean operative time of the last 5 patients in the MIVAT group was estimated. The rate of temporary hypoparathyroidism was significantly lower in MIVAT group compared with the convention group, and the incidences of other complications had no significant difference. With regard to the completeness of operation and the prognosis of tumor, no differences were found between the 2 groups.MIVAT can be safely applied in PTMC patients with positive impact on patients outcome by comparable results to a conventional procedure after a median follow-up of 5 years. Thus it is a better alternative therapeutic treatment for patients with PTMC.