Robotic thyroidectomy and cervical neck dissection for thyroid cancer

Paek, Se Hyun; Kang, Kyung Ho

doi:10.21037/gs.2015.10.04

Cited by 14 publications

(7 citation statements)

References 44 publications

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“…Nowadays, literature confirms the feasibility of this procedure, with acceptable outcomes in terms of complications. 23,24 In our series, 16% of patients had postoperative transient hypocalcemia, then gradually resolved with oral calcium intake; 2.44% had transient hoarseness, and only 3.3% of the patients presented vocal cord palsy requiring logopedy. Only 2 patients required a cervicotomy to control postoperative bleeding, otherwise conservatively managed, and 8 patients experienced neck or chest paresthesia, gradually resolved in few days.…”

Section: Discussionmentioning

confidence: 52%

Evolution Strategies in Transaxillary Robotic Thyroidectomy: Considerations on the First 449 Cases Performed

Piccoli

Mullineris

Gozzo

et al. 2019

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Background: In the past 20 years, the fast spread of new surgical technologies has reached an important peak with the advent of the robotic surgery. Many studies have been run about a cosmetic desire to avoid neck scars after thyroid surgery and this has led to the development of remote access robotic thyroidectomy (RT). Among the various RT approaches, unilateral transaxillary access is one of the most widely used, reporting excellent results in terms of feasibility and patient's compliance. The mini-invasive technique demonstrated many potential shortcoming overcomes with the robotic approach. At our institution a team of 3 skilled endocrine surgeons with experience in laparoscopic and robotic procedures performed RT. Our aim is to report our 8-year single-centre robot-assisted thyroidectomy experience, by applying a gasless unilateral transaxillary approach with the so-called hybrid technique, and to demonstrate its safety and feasibility. Methods: In the period between September 2010 and June 2018 at our institution, a total of 472 patients underwent thyroid and parathyroid transaxillary surgery. The hybrid technique was applied for all the robotic procedures. A total of 412 procedures were performed with the use of external “Modena Retractor” (CEATEC ® Medizintechnik) and with 3 surgeons. According to international guidelines, our indications for robotic surgery were benign lesions with a diameter <5 cm, Graves' disease, well-differentiated thyroid cancers, and parathyroid adenomas. Results: In this series, a total of 449 cases were registered. General data of patients were analyzed: gender, age, body mass index, tumor size, preoperative fine-needle aspiration examination, definitive histological examination, operative time, and postoperative complications. Conclusions: This study confirms the application of robotic approach in thyroid surgery as a feasible technique in terms of safety and complications risk. The hybrid technique, together with a dedicated surgical team, can lead to obtaining the same outcomes of traditional anterior cervicotomic surgery, adding a scarless thyroidectomy.

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Section: Discussionmentioning

confidence: 52%

Evolution Strategies in Transaxillary Robotic Thyroidectomy: Considerations on the First 449 Cases Performed

Piccoli

Mullineris

Gozzo

et al. 2019

Journal of Laparoendoscopic & Advanced Surgical Techniques

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“…Conventional OT has already demonstrated excellent results for a long time. However, robotic-assisted thyroid surgery is relatively controversial [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Safety and Efficacy of Transoral Robotic Thyroidectomy for Thyroid Tumor: A Systematic Review and Meta-Analysis

Kang

Cho

Stybayeva

et al. 2022

Cancers

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Background: To assess the safety and effectiveness of transoral robotic thyroidectomy (TORT) in thyroid tumor. Methods: PubMed, Embase, Web of Science, SCOPUS, Cochrane database, and Google Scholar up to June 2022. Studies comparing outcomes and complications between TORT and control groups (robotic bilateral axillo-breast, trans-axillary, postauricular approach, conventional open thyroidectomy (OT), and transoral endoscopic approach) were analyzed. Results: Ten studies of 1420 individuals. The operative time (SMD 1.15, 95%CI [0.48; 1.89]) was significantly longer and the number of retrieved lymph nodes (LNs) (SMD −0.27, 95%CI [−0.39; −0.16]) was fewer in TORT than in the control group. The postoperative cosmetic satisfaction score (SMD 0.60, 95%CI [0.28; 0.92]) was statistically higher in TORT than in the control group. In subgroup analysis, there was no significant difference between robotic surgeries. However, TORT had significantly longer operative times (SMD 2.08, 95%CI [0.95; 3.20]) and fewer retrieved LNs (SMD −0.32, 95%CI [−0.46; −0.17]) than OT. TORT satisfied significantly more patients in cosmetic view. However, it increased hospitalization days and postoperative pain on the operation day and first day compared to OT. Conclusions: TORT is not inferior to other robotic-assisted approaches. Its operation time and hospitalization days are longer and postoperative pain is greater than OT, although its cosmetic satisfaction is high.

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“…For instance, unilateral axillary–breast approach is difficult to remove the contralateral thyroid, while bilateral axillary–breast approach requires more incisions. [ 21 ]…”

Section: Discussionmentioning

confidence: 99%

Total areola approach for endoscopic thyroidectomy: Six years of experience with the same surgeon

Liu

Wang

Lin

et al. 2022

Journal of Minimal Access Surgery

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Background: Scarless endoscopic thyroidectomy (ET) is increasingly accepted by the growing amount of surgeons. The target of this study is to assess the efficacy and summarise the experiences of total areola approach for ET (TAAET). Subjects and Methods: TAAET was performed on 529 patients between January 2016 and October 2021. All operated patients were divided into two groups according to the chronological order. Demographic data, perioperative data and post-operative complications were collected to assess the effectiveness of TAAET. Results: Five hundred and twenty-eight patients were successfully treated with TAAET, while 1 case was converted to open surgery due to bleeding. The surgical approach consists of lobectomy or total thyroidectomy with or without central lymph node dissection. The post-operative pathology of 433 (81.9%) patients was diagnosed with T1 ~2N0M0. The average number of unilateral lymph node dissection was 7.72 ± 2.44 while the bilateral lymph node was 10.70 ± 3.72. In terms of complications, 38 cases had transient hoarseness, 28 cases had tetany and numbness, 3 cases had post-operative bleeding, 1 case had infection and 33 cases had subcutaneous fluid. There were statistically significant differences between the two groups with respect to transient hoarseness ( P < 0.001), tetany and numbness ( P = 0.005), intraoperative blood loss ( P = 0.003) and operation time for malignant tumour ( P < 0.001) because of the accumulation of surgical experience and the maturation of technology. Conclusions: TAAET which conforms to the anatomical pathway of open thyroidectomy is a safe, effective and feasible technique and is highly suitable for novices.

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Robotic thyroidectomy and cervical neck dissection for thyroid cancer

Cited by 14 publications

References 44 publications

Evolution Strategies in Transaxillary Robotic Thyroidectomy: Considerations on the First 449 Cases Performed

Evolution Strategies in Transaxillary Robotic Thyroidectomy: Considerations on the First 449 Cases Performed

Safety and Efficacy of Transoral Robotic Thyroidectomy for Thyroid Tumor: A Systematic Review and Meta-Analysis

Total areola approach for endoscopic thyroidectomy: Six years of experience with the same surgeon

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