Robotic Thyroidectomy

Abstract

Both GUA and postauricular facelift approaches are feasible, with no significant adverse events in patients, and result in excellent cosmesis. However, a GUA approach seems to be superior when performing total thyroidectomy using a unilateral incision based on the preliminary result.

Robotic thyroidectomy: Evolution and Outcomes

“…Indications for transaxillary robotic thyroidectomy include benign thyroid nodules less than 5 cm, differentiated thyroid carcinoma less than 4 cm in diameter regardless of minimal extrathyroidal extension, and small metastatic lymph nodes in the central and lateral compartment [19,20]. Exclusion criteria for this approach includes gross extrathyroidal extension, multiple or large metastatic lymph nodes in the central or lateral compartment, patients with a history of neck surgery or irradiation, and distant metastasis [14].…”

“…The facelift approach is familiar to the head and neck surgeons, which is widely used in parotidectomy, submandibular gland, and branchial cleft cyst excision [24][25][26]. This approach allows smaller dissection area and shorter distance from the incision site to the thyroid gland compared with the transaxillary approach [20]. The advantage of this approach is that the scar is concealed beneath the auricle and hair, particularly in female patients.…”

“…The disadvantages of this approach are narrow working space and technical difficulty to approach the contralateral thyroid lobe [28]. Another disadvantage of this approach is the transient decrease of sensation in the auricle area innervated by the great auricular nerve, or the possibility of transient paralysis of the marginal branch of facial nerve [20,27]. Usually 3 robotic arms including endoscopic camera, Harmonic scalpel, and Maryland dissectors can be used in facelift thyroidectomy.…”

“…Indication for postauricular facelift robotic thyroidectomy is similar to transaxillary thyroidectomy [20]. However, the transaxillary approach is preferred for total thyroidectomy over the facelift approach due to the limitation of the surgical view of the contralateral thyroid lobe and the contralateral recurrent laryngeal nerve via facelift approach.…”

Phase‐sensitive fluorescence detector for parathyroid glands during thyroidectomy: A preliminary report

“…Localization technologies were developed rapidly since Paras et al published the autofluorescence characteristics of the parathyroid glands. [20,21] These methods differ from the conventional open surgery and are intended for operations with a narrow view. [16][17][18][19] However, this technique has three limitations.…”