Operative outcomes of robot-assisted transaxillary thyroid surgery for benign thyroid disease: early experience in 50 patients

Axente, Dan; Silaghi, Horațiu; Silaghi, Cristina Alina; Major, Zoltán Zsigmond; Micu, C.; Constantea, N.

doi:10.1007/s00423-013-1085-2

Cited by 13 publications

(14 citation statements)

References 25 publications

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“…Thus, it is very difficult to compare the outcomes of different surgical approaches. Conversion to an open neck approach is described by different authors in both position [6, 8, 11, 17, 21], but the major number of conversion has been described in patient in KP, so we can not assume that the CP for European patients is worst than the KP. The length of the axilla skin incision with a mean length of 5.8 ± 1.5 cm depends on the technical devices used to perform the flap to reach the thyroid.…”

Section: Discussionmentioning

confidence: 99%

“…The RATS is a surgical multistep technique dived in consecutive phases, such as working space, docking time and console time [7, 11–15]. From this review not all the step are described, sometimes the working space and the docking time are considered together, other author in the total operative time do not consider the docking [20], so that it is difficult to know which is the step more time-consuming and technically demanding.…”

Section: Discussionmentioning

confidence: 99%

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Advances in Robotic Transaxillary Thyroidectomy in Europe

et al. 2017

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Purpose of reviewThe robotic surgical approach for minimally invasive thyroid surgery has been well described from the Korean surgeons and shows a wide spread diffusion in Asian area. This paper gives a systematic review aiming to pointed out the interest and the way of behaving of the European surgeons about the role of the robotic thyroidectomy (RT).Recent findingsA literature search was performed using Pubmed, MEDLINE, Cochrane and ClinicalTrials.gov databases, including only papers wrote from european surgeons enrolling patients operated in Europe. Outcomes of interest included patients characteristics, patients position, surgical devices, surgical technique, surgical outcomes, and complications. Eighteen studies have been included in the analysis, published from 2011 to 2017. An overall number of 1108 patients were treated in studies included. In the 44.4% of studies (eight trials), the Kuppersmith position was chosen, whereas in the 22.2% (four trials), the Chung position was selected, with a mean length on axilla skin incision of 5.8 ± 1.5 cm. Considering the characteristics of the surgical technique, the mean total surgical time was 166.8 ± 36.6 min (including total thyroidectomy and loboisthmectomy together), divided three consecutive phases, such as mean working space was 50.7 ± 21.8 min, mean docking time 16.0 ± 11.9 min and mean console time 102.87 ± 38.8 min. Considering the complications, only 50% of studies included reported data about acute complications. In particular, the most frequent was hypocalcemia, occurring in 32 cases (2.9%). RLN palsy occurred in 29 patients (2.6%), definitive in 13.8% of these cases and transient in 86.2%. Only nine studies reported the discharge time, with a mean of 2.4 ± 1.2 days after surgery.SummaryDespite the papers included in the study show a different way of collecting data, the transaxillary approach for robotic thyroidectomy for European patients is both feasible and safe. This procedure has to be carried out by surgeons expert in thyroid surgery with knowledge in robotic procedure. In the future, the incoming of dedicated instruments could improve and developed this technique.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Advances in Robotic Transaxillary Thyroidectomy in Europe

et al. 2017

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“…The incision is made using a 15 blade, and the subcutaneous flap is raised using electrocautery. It is Transient VC palsy [5], permanent VC palsy [3], Temporary hypoparathyroidism [12], temporary MM nerve injury [5], earlobe numbness [6], seroma [21], hematoma [2], chyle leak [1], skin flap ischemia [2] TT or less: 6; TT + MRND: 10 PTC, papillary thyroid cancer; FTC, follicular thyroid cancer; HT, hemithyroidectomy; TT, total thyroidectomy; MRND, modified radical neck dissection. A B very important to preserve the fascia overlying the pectoralis major muscle to prevent postoperative adhesions which may lead to increased discomfort and pain over the chest area.…”

Section: Working Space Formationmentioning

confidence: 99%

“…Using a robotic system helped to overcome some of the limitations of the endoscopic procedures such as reduced range of motion, and impaired eye-hand coordination (while relying on an unstable 2-dimentional view) (3,(5)(6)(7). Because of this, robotic thyroidectomy has become increasingly popular around the world (8-10) attracting both surgeons and patients searching for new and innovative procedures and allowing for the removal of thyroid glands with a superior cosmetic result (4,6,8) when compared to the conventional open thyroidectomy procedures.…”

Section: Introductionmentioning

confidence: 99%

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Overview of robotic thyroidectomy

et al. 2017

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With the advancement and adaptation of technology, there has been a tremendous evolution in the surgical approaches for thyroidectomy. Robotic thyroidectomy has become increasingly popular worldwide attracting both surgeons and patients searching for new and innovative techniques for thyroidectomy with a superior cosmetic result when compared to the conventional open procedures. In this review, we describe the following surgical approaches for robotic thyroidectomy: transaxillary, retroauricular (facelift) and transoral. The advantages and disadvantages as well as limitations of each approach are examined, and future directions of robotic thyroidectomy are discussed.

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Conversion rates in robotic thyroid surgery: A systematic review and meta‐analysis

Martino

Nitro

Pasquale

et al. 2022

Robotics Computer Surgery

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Objective To define the conversion risk to open procedure during robot‐assisted thyroid surgery (RATS) identifying potential specific subclasses of procedures or accesses at higher conversion risk. Methods In a PRISMA‐compliant framework, all original prospective studies providing RATS conversion rates from multiple databases were pooled in a random‐effects meta‐analysis. Conversion rates were compared between different typologies of thyroid surgery and robotic access. Results 13 studies were deemed eligible. Four conversions from two studies were reported out of 398 procedures. No significant heterogeneity was observed (Cochran's Q p = 0.932; I2 = 0%). The pooled conversion rate was 1% (95% confidence interval, 0.1%–2%). The ANOVA‐Q test failed to show significant differences when comparing type of thyroid surgery or robotic access (respectively p = 0.766 and p = 0.457). Conclusion While the conversion rate appears consistently low across studies, prospective data collection and systematic reporting of procedural complications are required for framing high‐risk procedures and accesses.

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Operative outcomes of robot-assisted transaxillary thyroid surgery for benign thyroid disease: early experience in 50 patients

Cited by 13 publications

References 25 publications

Advances in Robotic Transaxillary Thyroidectomy in Europe

Advances in Robotic Transaxillary Thyroidectomy in Europe

Overview of robotic thyroidectomy

Conversion rates in robotic thyroid surgery: A systematic review and meta‐analysis

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