Cosmetic Result and Overall Satisfaction after Minimally Invasive Video‐assisted Thyroidectomy (MIVAT) versus Robot‐assisted Transaxillary Thyroidectomy (RATT): A Prospective Randomized Study

Materazzi, Gabriele; Fregoli, Lorenzo; Manzini, Gabriele; Baggiani, Angelo; Miccoli, Mario; Miccoli, Paolo

doi:10.1007/s00268-014-2483-5

Cited by 42 publications

(29 citation statements)

References 66 publications

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“…From this review not all the step are described, sometimes the working space and the docking time are considered together, other author in the total operative time do not consider the docking [20], so that it is difficult to know which is the step more time-consuming and technically demanding. The outcomes results comparable to other conventional technique in terms of postoperative hypocalcemia, recurrent laryngeal nerve palsy, definitive laryngeal nerve, and hospital length stay [27•].…”

Section: Discussionmentioning

confidence: 99%

“…Lallemant [17] described the cosmetic results of the scar and 16 patients on a total of 20 were either satisfied or very satisfied. Materazzi [20] with a patient scar assessment questionnaire compare two different thyroid techniques: the RATS and the minimally invasive video-assisted thyroidectomy (MIVAT). The appearance and satisfaction with scar appearance scores significantly favored MIVAT.…”

Section: Discussionmentioning

confidence: 99%

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Advances in Robotic Transaxillary Thyroidectomy in Europe

et al. 2017

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Purpose of reviewThe robotic surgical approach for minimally invasive thyroid surgery has been well described from the Korean surgeons and shows a wide spread diffusion in Asian area. This paper gives a systematic review aiming to pointed out the interest and the way of behaving of the European surgeons about the role of the robotic thyroidectomy (RT).Recent findingsA literature search was performed using Pubmed, MEDLINE, Cochrane and ClinicalTrials.gov databases, including only papers wrote from european surgeons enrolling patients operated in Europe. Outcomes of interest included patients characteristics, patients position, surgical devices, surgical technique, surgical outcomes, and complications. Eighteen studies have been included in the analysis, published from 2011 to 2017. An overall number of 1108 patients were treated in studies included. In the 44.4% of studies (eight trials), the Kuppersmith position was chosen, whereas in the 22.2% (four trials), the Chung position was selected, with a mean length on axilla skin incision of 5.8 ± 1.5 cm. Considering the characteristics of the surgical technique, the mean total surgical time was 166.8 ± 36.6 min (including total thyroidectomy and loboisthmectomy together), divided three consecutive phases, such as mean working space was 50.7 ± 21.8 min, mean docking time 16.0 ± 11.9 min and mean console time 102.87 ± 38.8 min. Considering the complications, only 50% of studies included reported data about acute complications. In particular, the most frequent was hypocalcemia, occurring in 32 cases (2.9%). RLN palsy occurred in 29 patients (2.6%), definitive in 13.8% of these cases and transient in 86.2%. Only nine studies reported the discharge time, with a mean of 2.4 ± 1.2 days after surgery.SummaryDespite the papers included in the study show a different way of collecting data, the transaxillary approach for robotic thyroidectomy for European patients is both feasible and safe. This procedure has to be carried out by surgeons expert in thyroid surgery with knowledge in robotic procedure. In the future, the incoming of dedicated instruments could improve and developed this technique.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Advances in Robotic Transaxillary Thyroidectomy in Europe

et al. 2017

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“…This is probably the reason behind the surprising result obtained when MIVAT was compared to robot-assisted trans-axillary thyroidectomy. In an ironic twist, what was originally developed to be "a thyroid surgery free of a neck scar" was not superior to MI-VAT in terms of patient's satisfaction (34). Furthermore, there is no unnatural neck extension, no subplatysmal flap elevation, and no strap muscle transection in MIVAT.…”

Section: Mivat's Advantagesmentioning

confidence: 99%

Minimally Invasive Video-Assisted Thyroidectomy (MIVAT) in the Era of Minimal Access Thyroid Surgery

Bakkar

Miccoli

2017

J Minim Invasive Surg Sci

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Background: In the era of minimal access thyroid surgery, the terms minimal access and minimally invasive are often used interchangeably and in most instances this is far from being accurate. The aim of this article is to examine the characteristics and potential of one of the first minimal access thyroid procedures described; minimally invasive video-assisted thyroidectomy (MI-VAT). Methods: The purpose of this article was obtained by almost two decades of experiences with the procedure at the authors' center, and a systemic literature review was undertaken of all available medical literature to evaluate available literature by conducting a PubMed search limited to articles originally written in English language between the years 1997 and 2016. The search was limited by using the terms: minimally invasive thyroid surgery, video-assisted, endoscopic, and robotic thyroidectomy. The procedure's design, radicality and safety, learning curve, cost, advantages and disadvantages were addressed. MIVAT's potential as a surgical tool for thyroid pathology was also addressed by evaluating its indications, contraindications, and limitations. Results: MIVAT is a gasless hybrid procedure that is comparable to conventional thyroidectomy (CT) in terms of radicality and safety, with the added advantage of reduced early postoperative voice and swallowing symptoms. MIVAT has a relatively rapid learning curve with an additional advantage over other minimal access procedures; the ability of being adopted by the low-volume surgeon at a cost and time comparable to CT, but with improved patient satisfaction. Furthermore, it is non-inferior to procedures free of a neck scar in terms of patient satisfaction. MIVAT's main drawback is that it is limited by its strict selection criteria. It is a viable treatment option for all types of thyroid pathologies. However, its role in therapeutic neck dissection remains to be validated. Conclusions: MIVAT is a safe and effective procedure which is obviously described in its name "minimally invasive". It seems that in the era of innovative technologies and scarless-in-the neck thyroid surgery, MIVAT is here to stay.

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“…The evidence for this is level 1b as in addition to the several case control and cohort studies evaluating patient-reported outcome measures [1, 28-30], there is also a randomised controlled trial to support this though the latter failed to demonstrate cosmetic superiority of the transaxillary robotic approach over minimally invasive video-assisted thyroidectomy [17]. …”

Section: Benefitsmentioning

confidence: 99%

“…The feasibility and safety of robotic thyroidectomy are not limited to studies from the Far East (where the majority originate), but also from high-volume centres in the UK, Europe, and North America [1, 15-17]. …”

Section: The Evidence Basementioning

confidence: 99%

Robotic Thyroid Surgery: Current Perspectives and Future Considerations

Aïdan

Arora

Lőrincz

et al. 2018

ORL

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Robotic transaxillary thyroidectomy, pioneered in South Korea, is firmly established throughout the Far East but remains controversial in Western practice. This relates to important population differences (anthropometry and culture) compounded by the smaller mean size of thyroid nodules operated on in South Korea due to a national thyroid cancer screening programme. There is now level 2 evidence (including from Western World centres) to support the safety, feasibility, and equivalence of the robotic approach to its open counterpart in terms of recurrent laryngeal nerve injury, hypoparathyroidism, haemorrhage, and oncological outcomes for differentiated thyroid cancer. Moreover, robotic thyroidectomy has been shown to be superior to open surgery for certain patient-reported outcome measures, namely scar cosmesis and pain. Downsides include its high cost, longer operative time, and risk of complications not encountered in open thyroidectomy (brachial plexus neurapraxia). Careful patient selection is paramount as this procedure is not for every patient, surgeon, or hospital. It should only be undertaken by high-volume surgeons operating as part of a multidisciplinary robotic team in specialised centres. Novel robotic approaches utilising the retroauricular and transoral routes for thyroidectomy have recently been described but further studies are required to establish their respective role in modern thyroid surgery.

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Cosmetic Result and Overall Satisfaction after Minimally Invasive Video‐assisted Thyroidectomy (MIVAT) versus Robot‐assisted Transaxillary Thyroidectomy (RATT): A Prospective Randomized Study

Abstract: RATT seems not to supersede MIVAT in terms of satisfaction when comparing two groups of patients undergoing thyroidectomy for benign disease.

Cited by 42 publications

References 66 publications

Advances in Robotic Transaxillary Thyroidectomy in Europe

Advances in Robotic Transaxillary Thyroidectomy in Europe

Minimally Invasive Video-Assisted Thyroidectomy (MIVAT) in the Era of Minimal Access Thyroid Surgery

Robotic Thyroid Surgery: Current Perspectives and Future Considerations

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