Gasless trans-axillary robotic thyroidectomy: the technique and evidence

Alzahrani, Hassan; Mohsin, Khuzema; Ali, Daniah Bu; Murad, Fadi; Kandil, Emad

doi:10.21037/gs.2017.06.04

Cited by 9 publications

(15 citation statements)

References 23 publications

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“…The transoral approach is similar to the transaxillary approach in that they both remove the incision from the central neck; however, transaxillary operations have unique complications not seen with TCA or TOETVA. This includes chest paresthesia and brachial plexus neuropathy that arise from the extensive flap dissections required to reach the central neck from a more remote location, 42 as well as the increased risks associated with a larger American body habitus 31 . TOETVA avoids these complications and has less flap dissection compared to other remote‐access techniques, with the additional benefit of decreased pain reported postoperatively 22 …”

Section: Discussionmentioning

confidence: 99%

Cosmetic outcomes following transoral versus transcervical thyroidectomy

et al. 2020

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Background: Central neck scars following thyroidectomy can negatively impact patient quality of life. Transoral endoscopic thyroidectomy can reduce postoperative cosmetic burden. Methods: Prospective cohort study of patients seen between June 2018 and January 2019. Scar cosmesis was determined using the validated Scar Cosmesis Assessment and Rating (SCAR) scale and a Visual Analog Scale (VAS) measuring color, contour, and irregularity. Results: Eighty-one patients (80% female, mean age 43.7 years) were analyzed, with 60% and 40% receiving transcervical and transoral thyroidectomy. Median time from surgery was 3.4 (range: 1-37.1) weeks. Mean SCAR score was greater for transcervical recipients (4.69 vs transoral 0.99, P < .001), indicating worse cosmesis. Mean surgeon-rated total VAS score was similarly increased for transcervical recipients (72.84 vs transoral 16.73, P < .001). Interrater reliability for both SCAR and total VAS scores was excellent (intraclass correlation 0.93; 95% CI: 0.90-0.95 for both). Conclusion: Transoral thyroidectomy provides significantly enhanced early cosmesis over the transcervical approach.

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Section: Discussionmentioning

confidence: 99%

Cosmetic outcomes following transoral versus transcervical thyroidectomy

et al. 2020

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“…A different range of ages with no gender preferences was considered. But we noticed that the number of female patients was higher than the male patients and this was explained by the physical and aesthetic concerns of the females compared with the males [1][2][3][4][5][6].…”

Section: Patient Characteristicsmentioning

confidence: 99%

“…Lobe and colleagues performed the first robotic-assisted trans-axillary thyroidectomy (RATT) in 2005 [2,3]. The first procedure, done by Da Vinci robotic system (Intuitive Surgical, Sunnyvale, California), was performed by Chung in 2007 [4].…”

Section: Introductionmentioning

confidence: 99%

“…And we noticed that, although the robotic thyroidectomy is a minimally invasive procedure with satisfying cosmetic results, its direction in the future is still debatable. Most robotic thyroidectomy techniques consist of a Da Vinci robotic system (Intuitive Surgical, Sunnyvale, California) with a three-dimensional vision giving a real-time visualization and analysis of tissue perfusion along with recurrent nerve identification and sparing [3]. In addition, a tremor filtration software contributes to the decrease in the operator's tremors.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Advantages of Robotic Over Open Thyroidectomy in Thyroid Diseases: A Systematic Review

Ismail¹,

Tavalla²,

Uppal³

et al. 2022

Cureus

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Over a hundred thousand thyroid surgeries are performed per year in the United States. Although conventional thyroidectomy has successful surgical outcomes, robotic minimally invasive procedures, known for their scar free (regarding the neck, no collar incision) surgical outcomes gained popularity through the years. Furthermore, these techniques are new and still debatable. The purpose is to know the advantages of robotic over open thyroidectomy in thyroid diseases. Note that we didn't aim to compare different robotic techniques due to the lack of data.We performed a systematic review comparing surgical approaches for thyroidectomy, open vs robotic techniques, from January 2017 to December 2021, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. All papers with no full free article access and not in the English language were excluded. The outcomes of interest were superior cosmetics outcome, costeffectiveness, limitations, operation time, length of hospital stay and postoperative pain or complications, and future outcomes.A literature search was carried out in electronic databases (PubMed, Google Scholar) in order to retrieve all papers comparing the effectiveness of robotic vs open thyroidectomy. An initial reference search yielded 433 articles. Finally, we chose nine studies covering different robotic thyroidectomy techniques compared to the open thyroidectomy approach. Promising results were seen in these studies, especially with superior cosmetic results, less post-operative pain, swallowing discomfort, and voice changes. In addition, the risk of recurrent laryngeal nerve injury is almost the same as the open approach. Multiple types of biases were caused by the selection of the population and the limitation of the studies to certain regions associated with the low numbers of robotic thyroidectomy approaches in Europe and the United States of America and the lack of randomized trials and long-term follow-up respectively. All studies discussed the importance of the surgeon's skills and the patient decision in choosing the appropriate approach for the thyroidectomy depending on the risk factors, a larger number of patients, and longer follow-up from multiple hospitals.

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“…Boyunda görünür skarı önleyebilmek amacı ile insizyonların aksilla, meme, göğüs duvarı veya retroauriküler bölgeye taşındığı endoskopik ve robotik yöntemler tanımlanmıştır (13)(14)(15)(16)(17)(18)(19)(20). Bu yöntemlerde boyunda insizyon olmasa da vücudun diğer bölümlerinde görünebilir insizyon skarı vardır.…”

Section: Mi̇ni̇mal İnvazi̇v Ti̇roi̇t Cerrahi̇si̇ni̇n Geli̇şi̇mi̇unclassified

Scarless thyroidectomy: transoral endoscopic thyroidectomy by vestibular approach

Uludağ¹,

İşgör²

2017

Sisli Etfal

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İzsiz tiroidektomi: Vestibüler yaklaşımla transoral endoskopik tiroidektomiVestibüler yaklaşımla transoral endoskopik tiroidektomi (TOETVA) minimal invaziv, görünür yara izi olmayan naturel orifis transluminal endoskopik cerrahi (Naturel orifice transluminal endoscopic surgery (NOTES) tekniktir. Ağız içinden vestibüler bölgeden uygulanan 1 adet 10 mm ve 2 adet 5 mm port yardımı ile düşük CO 2 basıncı altında tamamen endoskopik olarak lobektomi veya total tiroidektomi uygulanabilir. Dünyada giderek uygulaması artmaktadır. Deneyimli merkezlerde seçilmiş hastalarda güvenli bir şekilde uygulabilmektedir. Bu çalışmada minimal invaziv tiroit cerrahisinin gelişimi, TOETVA için hasta seçimi ve dışlama kriterleri, bölgesel anatomi, ameliyat tekniği, preoperatif ve postoperatif bakım, yöntemin avantajları, dezavantajları ve olası komplikasyonları tartışılacaktır. Anahtar kelimeler: Endoskopik tiroidektomi, izsiz tiroidektomi, minimal invaziv endoskopik tiroidektomi

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Gasless trans-axillary robotic thyroidectomy: the technique and evidence

Cited by 9 publications

References 23 publications

Cosmetic outcomes following transoral versus transcervical thyroidectomy

Cosmetic outcomes following transoral versus transcervical thyroidectomy

The Advantages of Robotic Over Open Thyroidectomy in Thyroid Diseases: A Systematic Review

Scarless thyroidectomy: transoral endoscopic thyroidectomy by vestibular approach

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