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Mini-Sternotomy for thyroid surgery is a useful approach for mediastinal and retrosternal goitres. A mini-sternotomy involves a midline osteotomy from the sternal notch down the manubrium to the second intercostal space, where a second horizontal osteotomy is performed. A thyroidectomy is attempted first via a cervical approach, before a powered saw is used to make the osteotomies and a sternal retractor used to access the mediastinum and a total thyroidectomy then completed. The sternum is closed with wires as a drain is placed and the wound closed in layers. The advantages, compared to a conventional sternotomy that continues from sternal notch to xiphoid process, include a smaller incision, decreased pain, faster recovery, shorter hospital stay and fewer complications.