Gasless trans-axillary robotic thyroidectomy: the introduction and principle

Aïdan, Patrick; Bechara, Maroun

doi:10.21037/gs.2017.03.19

Cited by 10 publications

(11 citation statements)

References 38 publications

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“…In our meta-analysis, cases with transient and permanent hypocalcaemia were merged, and we observed a tendency of fewer cases of hypoparathyroidism in the endoscopic group in comparison with conventional thyroidectomy. This might be due to improved visualisation of the surgical field and better identification of the important structures such as the parathyroid glands [ 26 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

Transaxillary gasless endoscopic thyroidectomy versus conventional open thyroidectomy: systematic review and meta-analysis.

Jasaitis

Midlenko

Bekenova

et al. 2021

Videosurgery and Other Miniinvasive Techniques

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Aim This systematic review and meta-analysis evaluates surgical outcome and safety results of conventional (OT) versus endoscopic transaxillary gasless thyroidectomies (ET). Material and methods A systematic literature search was performed. The weighted mean differences or the odd ratios with corresponding 95% CIs were examined for surgical outcomes and complications. The results were analysed using fixed- or random-effects models. The heterogeneity was checked by the Cochran Q test and the extent of inconsistency was evaluated by the I 2 statistic. Results Ten studies and 1597 patients were included. All studies found that ET required longer operative time. Postoperative pain was significantly lower after ET on day 1 and day 7. No statistical difference was found in complication rates. Conclusions ET has disadvantages such as longer surgery time, but it is a feasible and safe procedure with lower postoperative pain and comparable complication rates to OT. However, good quality prospective randomised studies are necessary to draw firmer conclusions.

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Section: Discussionmentioning

confidence: 99%

Transaxillary gasless endoscopic thyroidectomy versus conventional open thyroidectomy: systematic review and meta-analysis.

Jasaitis

Midlenko

Bekenova

et al. 2021

Videosurgery and Other Miniinvasive Techniques

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“…Recently, intraoperative nerve monitoring [38][39][40][41], a transoral approach [42][43][44][45][46], and robotic surgery [47][48][49][50] have emerged in endoscopic thyroid surgery. We believe that intraoperative nerve monitoring is efficient for identifying and preserving the recurrent nerve and external branch of the superior laryngeal nerve.…”

Section: Discussionmentioning

confidence: 99%

Video-assisted neck surgery (VANS) using a gasless lifting procedure for thyroid and parathyroid diseases: “The VANS method from A to Z”

Shimizu

Okamura

et al. 2019

Surg Today

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Purpose To describe and evaluate our video-assisted neck surgery (VANS) method for thyroid and parathyroid diseases. Methods We describe in detail the VANS method for enucleation, lobectomy, total (nearly total) thyroidectomy, and lymph node dissection for malignancy and Graves' disease. In collaboration with the Japan Society of Endoscopic Surgery (JSES), we evaluated several aspects of this method. The JSES evaluated the method for working-space formation and surgical complications, whereas we examined the learning curve of the surgeons, and the cosmetic satisfaction of the patients and the degree of numbness and pain they experienced. We also asked patients who underwent conventional surgery whether they would have selected VANS had it been available. Results The working space for 81.5% of the procedures in Japan was created using the gasless lifting method. The learning curve, considering both blood loss and operating time, decreased after 30 cases. Both factors improved for tumors smaller than 5 cm in diameter. Over 60% of the patients who underwent conventional surgery stated that they would have selected VANS, had it been available. Postoperative pain was worse after conventional surgery than after VANS, but neck numbness after VANS was more frequent than expected. Conclusions The VANS method is a feasible, safe, and cost-effective procedure with clear cosmetic advantages over conventional surgery.

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“…Therefore, iatrogenic HNP should be prevented as much as possible. GTAET a generally safe surgical procedure that has substantial cosmetic effects, and IHNP is an unreported complication of GTAET before, and this first reported cases will add our knowledge and experience to diagnose and treat this rare complication [ 11 ]. Although no definitive etiologies were found, male patient, strong SCM and strap muscle, cervical hyperextension, forceful surgical and anesthetic manipulations may be the risk factors for iatrogenic HNP, which should be taken into account before performing a GTAET.…”

Section: Discussionmentioning

confidence: 99%

Hypoglossal nerve palsy after gasless trans-axillary endoscopic thyroidectomy: a case report

et al. 2021

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Background Gasless trans-axillary endoscopic thyroidectomy (GTAET) has satisfactory cosmetic effects for the patients who have benign goiter and small thyroid carcinoma, however the complications of this surgical procedure have not been fully documented. Ipsilateral hypoglossal nerve palsy (IHNP) associated with GTAET has never been reported before. Case presentation A 33-year old male patient presented with a 4 × 5 mm solid thyroid nodule in the right lobe. Papillary thyroid carcinoma was confirmed by the fine needle aspiration. He had strong cosmetic demand, therefore GTAET for right lobectomy and central cervical lymphadenectomy was performed in a supine position with cervical extension. Six hours after the operation, he developed tongue deviation to the right side, speech and swallowing difficulties, indicating IHNP. Head and cervical MRI showed no abnormality. The intravenous steroid was used for three days, and oral vitamin B1 and mecobalamin was prescribed for 1 month. Nine days after surgery, he was discharged. Three months after the operation, all the symptoms were completely resolved. Conclusions To the best of the authors’ knowledge, this is the first case of IHNP after GTAET, which will be valuable to add our knowledge to diagnose and treat rare complications of GTAET.

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Gasless trans-axillary robotic thyroidectomy: the introduction and principle

Cited by 10 publications

References 38 publications

Transaxillary gasless endoscopic thyroidectomy versus conventional open thyroidectomy: systematic review and meta-analysis.

Transaxillary gasless endoscopic thyroidectomy versus conventional open thyroidectomy: systematic review and meta-analysis.

Video-assisted neck surgery (VANS) using a gasless lifting procedure for thyroid and parathyroid diseases: “The VANS method from A to Z”

Hypoglossal nerve palsy after gasless trans-axillary endoscopic thyroidectomy: a case report

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