Modified robotic-assisted thyroidectomy: An initial experience with the retroauricular approach

Abstract

Single-incision retroauricular robotic hemithyroidectomy can be a safe and feasible alternative to other remote access techniques. Neck lift surgery can be performed safely in a select group of patients. However, future studies are warranted to further evaluate the benefits and limitations of this novel approach.

Robotic retroauricular thyroid surgery

“…Several studies have reported the safety of the retroauricular approach (12,(15)(16)(17)(18), and showed comparable complication rate to the conventional open approach (19). On the other hand, there are other risks specific to this approach, which is injury to the flap or GAN.…”

“…The surgeons have to be aware of those risks during the procedure to prevent them, by careful dissection of the flap and identified and preservation of the nerve. However, it was reported that some patients develop temporary hypoesthesia at the surgery site or the area corresponding to the distribution of GAN, in spite of preserving the nerve, which improve spontaneously (12,15).…”

“…The flap is created deep to the platysma as described by Terris et al (12,14). However, in our practice the flap is elevated superficial to the platysma with a special Metzenbaum scissor, which is an approach utilized by plastic surgeons in facelift procedures (15,16). In the condition of using this approach, surgeons have to be aware to avoid performing it on smoker patients.…”

“…Graves' disease is an absolute contraindication, since these patients require total thyroidectomy. In cases of thyroid cancer, this approach should be offered only to patients with differentiated thyroid cancer, with no evidence of extrathyroid extension or pathological lymphadenopathy (14,15).…”

Robotic Retroauricular Thyroidectomy

“…Terris et al first described Robotic Retroauricular Thyroidectomy (RRT) in 2011, as 'robotic facelift thyroidectomy' [5]. Later cadaver study case series and original articles were reported in the literature [6][7][8][9][10][11][12][13][14].…”