Well-differentiated thyroid cancer and robotic transaxillary surgery at a North American institution

Garstka, Meghan; Mohsin, Khuzema; Ali, Daniah Bu; Shalaby, Hosam; Ibraheem, Kareem; Farag, Mahmoud M.; Kang, Sang‐Wook

doi:10.1016/j.jss.2018.03.030

Cited by 19 publications

(40 citation statements)

References 11 publications

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“…In 2018 we already described our results on differentiated thyroid carcinomas proving RATT as oncologically safe [9]. Moreover, our results are in accordance to previous studies [2,4,33] which demonstrated RATT as safe and feasible even in case of malignant nodules in properly selected cases. Besides, some encouraging results are emerging regarding robot-assisted lateral neck dissection, although almost limited to the Korean experience [34].…”

Section: Discussionsupporting

confidence: 89%

Robotic transaxillary thyroidectomy: time to expand indications?

et al. 2023

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In 2016, the American Thyroid Association published a statement on remote-access thyroid surgery claiming that it should be reserved to patients with thyroid nodule ≤ 3 cm, thyroid lobe < 6 cm and without thyroiditis. We retrospectively enrolled all patients who underwent robotic transaxillary thyroidectomy between February 2012 and March 2022. We compared surgical outcomes between patients who presented a thyroid gland with a nodule ≤ 3 cm, thyroid lobe < 6 cm and without thyroiditis (Group A) and patients without these features (Group B). The rate of overall complications resulted comparable (p = 0.399), as well as the operative time (p = 0.477) and the hospital stay (p = 0.305). Moreover, bleeding resulted associated to thyroid nodule > 3 cm (p = 0.015), although all bleedings but one occurred in the remote-access site from the axilla to the neck. In experienced hands, robotic transaxillary thyroidectomy is feasible and safe even in patients with large thyroid nodules or thyroiditis.

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Section: Discussionsupporting

confidence: 89%

Robotic transaxillary thyroidectomy: time to expand indications?

et al. 2023

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“…21,22 Patients included in the RAA cohort were offered these procedures based on selection criteria described previously. 19,[23][24][25][26] In a broad sense, these included those with a thyroid lobe <10 cm in patients highly motivated to avoid an anterior-cervical scar. Cytopathologically benign and indeterminate nodules and patients with Graves' disease were considered for surgical candidacy.…”

Section: Methodsmentioning

confidence: 99%

Remote-Access Thyroidectomy: A Multi-Institutional North American Experience with Transaxillary, Robotic Facelift, and Transoral Endoscopic Vestibular Approaches

Russell

Razavi

Garstka

et al. 2019

Journal of the American College of Surgeons

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BACKGROUND: Many remote-access approaches (RAAs) to the thyroid have been described to circumvent anterior neck scarring, including the transaxillary, robotic facelift, and transoral endoscopic vestibular approaches. These techniques have been popularized in Asia, but adoption has been slow in North America. We aimed to examine multi-institutional North American outcomes with RAA thyroidectomy in the context of these institutions' transcervical approach (TCA) outcomes. STUDY DESIGN: Cases of lobectomy and total thyroidectomy via transaxillary, robotic facelift, and transoral endoscopic vestibular approaches were reviewed. Demographic characteristics, outcomes, and complications were compared with the same measures in patients undergoing lobectomy and total thyroidectomy via TCA by the primary RAA surgeons at each institution. Patients who underwent parathyroidectomy or other concomitant neck dissection procedures were excluded. RESULTS: Two hundred and sixteen RAA thyroidectomies were attempted (92 transoral endoscopic vestibular approaches, 70 transaxillary, and 54 robotic facelift) and 410 TCA thyroidectomies were performed. There was no difference in mean index nodule sizes between RAA (2.8 ± 1.6 cm) and TCA (2.9 ± 1.9 cm) cohorts (p = 0.72). Median operative times for

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“…The Authors reported comparable outcomes in terms of mean tumor size, number of positive microscopic margins and number of lymph nodes removed when lymph node dissections were associated. No statistically significant difference in postoperative thyroglobulin levels was documented, with a comparable follow-up period, and no significant difference in recurrence rate was reported; in particular, no recurrence was reported in the robotic group ( 38 ).…”

Section: Robot-assisted Transaxillary Thyroidectomy (Ratt)mentioning

confidence: 84%

“…Garstka et al. ( 38 ) published a comparative study including DTC patients who underwent robot-assisted transaxillary or conventional cervical approach with or without lymph node dissection. A total of 144 surgeries were included, 35 out of 144 were robotics.…”

Section: Robot-assisted Transaxillary Thyroidectomy (Ratt)mentioning

confidence: 99%

Recent Trends in Surgical Approach to Thyroid Cancer

et al. 2021

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Over the past decade, the incidence of thyroid cancer has rapidly increased worldwide, and thyroid surgery has become one of the most common performed surgical procedure. Even though conventional open thyroidectomy remains the gold standard, this approach leaves a neck scar which could be worrying mainly for young women. The recent progress in surgical technology, as well as patient cosmetic requests, have led to the development of alternative access to the thyroid lodge. Thus, alternative techniques have been established in order to potentially provide a more appealing cosmetic result, both with a minimally-invasive cervical or remote-access approach. However, the introduction of these new techniques was initially approached with caution due to technical challenges, the introduction of new complications and, above all, skepticism about the oncologic effectiveness. Among several alternative approaches proposed, the minimally invasive video-assisted thyroidectomy and the robot-assisted transaxillary thyroidectomy became popular and obtained the favor of the scientific community. Moreover, the recent introduction of the trans-oral endoscopic thyroidectomy with vestibular approach, although the safety and the efficacy are still under discussion, deserves particular attention since it represents the only technique truly scarless and provides the best cometic result. The purpose of this article is to provide an overview of the current main alternative approaches for the treatment of thyroid cancer with particular focus on the oncological effectiveness of the procedures.

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Well-differentiated thyroid cancer and robotic transaxillary surgery at a North American institution

Cited by 19 publications

References 11 publications

Robotic transaxillary thyroidectomy: time to expand indications?

Robotic transaxillary thyroidectomy: time to expand indications?

Remote-Access Thyroidectomy: A Multi-Institutional North American Experience with Transaxillary, Robotic Facelift, and Transoral Endoscopic Vestibular Approaches

Recent Trends in Surgical Approach to Thyroid Cancer

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