Transaxillary Robotic Thyroid Surgery: A Preliminary European Experience

Abstract

Background: Robot-assisted endoscopic transaxillary thyroidectomy is an emerging surgical technique that needs to be evaluated in European patients. We evaluate the feasibility and preliminary results of our experience of this technique in a cohort of patients from within a single European university hospital (Nîmes, France). Methods: We performed a retrospective review of the first 23 patients, treated consecutively between September 2010 and June 2012. Results: Nine patients underwent total thyroidectomy and 14 patients lobectomies. All procedures were completed successfully with a mean total operative time of 134 min. We observed a single case of internal jugular vein injury during the console time. No instances of persistent complications were observed; however, minor postoperative events occurred in 5 patients. Pathological diagnoses included benign follicular adenoma in 18 patients, benign adenoma with lymphoid thyroiditis in 1 patient, and benign adenoma with Graves' disease in 4 patients. Conclusions: Robotic thyroid surgery is feasible in European patients and can be safely performed on selected patients. This technique has infrequent minor complications and provides a high level of satisfaction.

Advances in Robotic Transaxillary Thyroidectomy in Europe

“…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.…”

Robotische Chirurgie – operiert der Roboter?

“…Due to this fact, surgeons from this area dispose of good results in cohorts with thousands of patients 9 99 . But also non-Asian teams use this approach, however, with clearly lower numbers of cases and mostly non-malignant diseases 1 90 92 .…”

“…Dementsprechend können die Operateure aus dieser Region auch gute Ergebnisse in Kohorten mit tausenden von Patienten aufweisen 9 99 . Aber auch nicht-asiatische Arbeitsgruppen verwenden diesen Zugang in deutlich geringeren Fallzahlen mit überwiegend nicht-malignen Erkrankungen 1 90 92 .…”

Transaxilläre Schilddrüsenchirurgie – nicht alles was neu ist, ist auch gut

“…Der [5]. Ist der Westen zu konservativ oder ist in einem Zeitalter des Kostendrucks (in Deutschland das DRG ["diagnosis related groups"] -System) und aufgrund westlicher Normen einfach (noch) kein Platz für eine aufwendige Operationsmethode, die als einzigen Vorteil die Vermeidung einer Narbe am Hals hat?…”