Factors affecting operative time in robotic thyroidectomy

Song, Chang Myeon; Jang, Youn Il; Ji, Yong Bae; Park, Jeong Seon; Kim, Dong Sun; Tae, Kyung

doi:10.1002/hed.25033

Cited by 18 publications

(14 citation statements)

References 36 publications

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“…There was no apparent steep learning curve although we might still be on the learning curve because this is our early case series; we have performed more than 700 robotic or endoscopic thyroidectomies via gasless transaxillary and postauricular facelift approaches since 2005, [26][27][28][29][30][31][32] and in our series using the gasless trans-axillary approach, the learning curve was about 35 cases. 34 Alternatively, our substantial experience of robotic and endoscopic thyroidectomy may be related to the absence of a steep learning curve in the transoral thyroidectomy series.…”

Section: Discussionmentioning

confidence: 99%

Early experience of transoral thyroidectomy: Comparison of robotic and endoscopic procedures

et al. 2018

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Background The aim of this study was to evaluate the feasibility, safety, and early surgical outcomes of transoral thyroidectomy and to compare robotic and endoscopic procedures. Methods A total of 37 patients underwent robotic (23 cases) or endoscopic (14 cases) transoral thyroidectomy. We compared the outcomes of the two procedures. Results Of the 37 patients, 2 were converted to the robotic facelift approach as a result of an intraoperative CO2 embolism and inability to remove the tumor. The mean operative time was 172.8 ± 37.5 minutes. Transient recurrent laryngeal nerve palsy occurred in one case, and transient hypoparathyroidism in two cases. Most of patients were satisfied with the postoperative cosmesis. There were no significant differences between the robotic and endoscopic procedures, except for operative time, which was significantly longer in the robotic group. Conclusion Robotic and endoscopic transoral thyroidectomies are both feasible and safe in appropriate patients.

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Section: Discussionmentioning

confidence: 99%

Early experience of transoral thyroidectomy: Comparison of robotic and endoscopic procedures

et al. 2018

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“…In 2017, Song et al [30] scrutinized factors affecting operative time in robotic thyroidectomy and reported that BMI ≥ 23 kg/m 2 and central compartment dissection were both independent risk factor for prolonged operative time. Moreover, Kandil et al [20] reported longer operative time in obese patients, either considering the flap creation and console time.…”

Section: Discussionmentioning

confidence: 99%

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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“…Many studies have described BABA methods, including how to make the BABA flap (2)(3)(4)10). BABA flap creation generally requires 30-40 minutes, increasing total operation time (5)(6)(7)(8). Appropriate training for BABA flap creation is very important for the successful implementation of BABA surgery.…”

Section: Discussionmentioning

confidence: 99%

“…The borders of the flap are from the bilateral axillae and breasts to the anterior neck up to the thyroid cartilage superiorly and the medial border of the sternocleidomastoid (SCM) muscle laterally (4). The mean time required to create a BABA flap has been reported to range from 30 to 40 minutes (5)(6)(7), accounting for a large portion of the operation time required for thyroid surgery using BABA (8). Thus, creation of a proper BABA flap is important for the success of BABA thyroid surgery, whether performed endoscopically or robotically.…”

Section: Introductionmentioning

confidence: 99%

Harmonic versus LigaSure for Flap Creation in Bilateral Axillary Breast Approach Thyroid Surgery

et al. 2020

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The bilateral axillary breast approach (BABA) is frequently utilized for remote access thyroid surgery. The first step in this surgical approach is to make a subcutaneous flap from the axilla to the neck, usually using a Harmonic ACE. Our institution has utilized LigaSure to create these flaps. This study reports comparative results with these 2 energy devices. Methods: Medical data and video clips from 73 patients who underwent robotic BABA thyroid surgery were retrospectively reviewed. Flaps for BABA were created by first and second year endocrine fellows under the guidance of an experienced endocrine surgeon. There were no criteria for allocation to energy devices. Results: Of the 73 patients, 31 and 42 underwent flap creation with the Harmonic ACE and LigaSure devices, respectively. Demographic characteristics were similar in the 2 groups. Mean time for flap creation was significantly shorter (33.46±8.33 vs. 38.27±7.14 min, P=0.012), and mean number of camera cleanings significantly lower (4.21±2.53 vs. 10.45±4.95, P<0.001), in the LigaSure group. Surgical site pain on day 2 was significantly lower in the LigaSure group. Postoperative bleeding and skin burn occurred only in patients in the Harmonic group. Conclusion: LigaSure showed better performance than the Harmonic ACE device for BABA flap creation, as shown by time for flap creation, postoperative pain scores, and complications. Because this study was a small sized retrospective comparison, large randomized controlled trials are needed to confirm these results.

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Factors affecting operative time in robotic thyroidectomy

Abstract: Body habitus and clinical nodal status in the central compartment should be considered in deciding the indications for robotic thyroidectomy.

Cited by 18 publications

References 36 publications

Early experience of transoral thyroidectomy: Comparison of robotic and endoscopic procedures

Early experience of transoral thyroidectomy: Comparison of robotic and endoscopic procedures

Robotic transaxillary thyroidectomy: time to expand indications?

Harmonic versus LigaSure for Flap Creation in Bilateral Axillary Breast Approach Thyroid Surgery

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