Thyroidectomy for Graves' Disease: A Feasibility Study of the Robotic Transaxillary Approach

Abstract

Introduction: Graves' disease (GD) is considered a relative contraindication for endoscopic approaches to the thyroid gland, due to a larger gland size and increased vascularity. Methods: A retrospective analysis of a single surgeon's experience was performed. We included all patients who underwent thyroidectomy for the treatment of GD over a 3-year period. Results: Twenty-five patients with GD were identified. Twelve of them underwent robotic thyroidectomy and 13 patients underwent conventional thyroidectomy. Age, gender, and BMI were similar in both groups (p > 0.05). The conventional approach allowed for resection of larger thyroid volumes (147.3 ± 153.6 ml), as compared to the robotic approach (62.3 ± 47.8 ml, p = 0.08). The average total operative times were similar in both groups (p = 0.98). There was no difference with respect to intraoperative blood loss (p = 0.49), duration of hospital stay (p = 0.38), and complication rates (p = 0.99). Conclusion: Robotic thyroidectomy is feasible and can be safely performed in appropriately selected patients with GD.

Comparison of Bilateral Axillo‐Breast Approach Robotic Thyroidectomy with Open Thyroidectomy for Graves’ Disease

“…There are a few published reports indicating that robotic surgery was feasible and safe for patients with Graves' disease; Noureldine et al reported that transaxillary robotic thyroidectomy had a similar operative time, intraoperative blood loss, duration of hospital stay, and complication rate as the open procedure [12]. Park et al also suggested that the complication rate of robotic thyroidectomy is comparable with open surgery [24].…”

“…Park et al also suggested that the complication rate of robotic thyroidectomy is comparable with open surgery [24]. However, a small sample size was the major drawback in these studies [11, 12, 15, 24]. Furthermore, most studies only evaluated subtotal thyroidectomy as the robotic procedure.…”

“…Although several reports demonstrated that robotic thyroidectomy is a valid option for patients with Graves' disease, there is an ongoing debate about whether robotic thyroidectomy is appropriate for these patients [11][12][13][14][15]. We reported our initial experience of bilateral axillo-breast approach robotic thyroidectomy (BABA RT) for Graves' disease and showed that it was a feasible and safe procedure [11].…”

Safety and Feasibility of Robotic Transaxillary Thyroidectomy for Graves’ Disease: A Retrospective Cohort Study

“…With experience accumulation and technology advancement, an attempt was made for thyroidectomy in patients with GD, which was almost impossible with the endoscopic approach [17]. Initial experiences of RTT for GD in other hospitals had provided promising results [18], but robotic thyroidectomy for GD remains controversial. Herein we evaluate the safety and feasibility of RTT for patients with GD in a larger sample of patients.…”

Can Robotic Thyroidectomy Be Performed Safely in Thyroid Carcinoma Patients?

“…In the study, one patient experienced permanent hypoparathyroidism, but none had major complications such as bleeding, open conversion, or permanent RLNI. The other retrospective study comparing RT and OT in Graves' disease patients [ 25 ], in which those with smaller-sized thyroid underwent RT, found no significant between-group differences in operation time, blood loss, or complication rate. RT might be performed safely in selected Graves' disease patients.…”