First Experience of Single-Port Robotic Areolar Approach Thyroidectomy

Choi, Young Rok; Yi, Jin Wook; Choi, Ji Hyun; Jeon, Mi Sook; Yu, Min-Jie; Lee, Hye Mi; Shin, Ae Sun

doi:10.21053/ceo.2023.00682

Clin Exp Otorhinolaryngol

2023

DOI: 10.21053/ceo.2023.00682

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First Experience of Single-Port Robotic Areolar Approach Thyroidectomy

Young Rok Choi¹,

Jin Wook Yi²,

Ji Hyun Choi³

et al.

Abstract: ObjectivesVarious minimally invasive thyroidectomy methods have been developed and actively used in several hospitals worldwide. Herein, we describe a newly developed minimally invasive thyroidectomy method that uses the da-Vinci SP and report the initial clinical results of single-port robotic areolar thyroidectomy (SPRA). MethodsA 3 cm semi-circular incision on the right areola and an 8 mm small incision on the left areola were created. A subcutaneous skin flap was created from the areola to the thyroid cart… Show more

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Cited by 4 publications

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Da Vinci single-port robotic system current application and future perspective in general surgery: A scoping review

Celotto,

Ramacciotti,

Mangano

et al. 2024

Surg Endosc

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Background The da Vinci Single-Port Robot System (DVSP) allows three robotic instruments and an articulated scope to be inserted through a single small incision. It received FDA approval in 2014 and was first introduced in 2018. The aim of this new system was to overcome the limitations of single-incision laparoscopic and robotic surgery. Since then, it has been approved for use only for urologic and transoral surgeries in some countries. It has been used as part of experimental protocols in general surgery. Objective By obtaining the CE mark at the end of January 2024, DVSP will soon enter the European market. This review aims to comprehensively describe the applications of DVSP in general surgery. Design A search of PubMed, Embase, and Ebsco databases up to March 2024 was conducted, with registration in PROSPERO (CRD42024536430), following the preferred reporting items for Systematic reviews and Meta-analyses for scoping review (PRISMA-Scr) guidelines. All the studies about the use of DVSP in general surgery were included. Results Fifty-six studies were included. The following surgical areas of use were identified: transabdominal and transanal colorectal, cholecystectomy, abdominal wall repair, upper gastroesophageal tract, liver, pancreas, breast, and thyroid surgery. The reported surgical and short-term outcomes are promising; a wide range of procedures have been performed safely. Some groups have found advantages, such as faster discharge, shorter operative time, and less postoperative pain compared to multiport robotic surgery. Conclusion Five years after its initial clinical applications, the use of the DVSP in general surgery procedures has demonstrated feasibility and safety. Hernia repair, cholecystectomy, and colorectal surgery emerge as the most frequently conducted interventions with this robotic system. Nevertheless, there is anticipation for further studies with larger sample sizes and extended follow-up periods to provide more comprehensive insights and data on the long-term outcomes, including the incidence of incisional hernia. Graphical Abstract

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Da Vinci single-port robotic system current application and future perspective in general surgery: A scoping review

Celotto,

Ramacciotti,

Mangano

et al. 2024

Surg Endosc

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Robotic pulmonary lobectomy without using intercostal sites: The first case of lung cancer surgery using the da Vinci SP surgical system in Japan

Kawaguchi,

Kaneda,

Ito

et al. 2024

Jpn J Chest Surg

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In the field of general thoracic surgery, multi-port robotic surgery and single-port thoracoscopic surgery have widely spread. The da Vinci SP surgical system, approved in September 2022, is a single-port system with only one robotic arm that is expected to further reduce invasiveness. The system is contra-indicated for cardiac surgery and an intercostal approach, and we report the first case of lung cancer surgery without an intercostal approach in Japan using this system. The patient was a 68-year-old man with 1.4 cm lung cancer, cT1bN0M0, in the lower lobe of his right lung. The operation was performed in a left lateral recumbent position, a 4 cm skin incision was placed below the costal arch, and an access port was created via the diaphragm. Three instruments and a camera were inserted from there, and a stapler was operated by an assistant with one instrument removed. The console time was 139 minutes with a small amount of blood loss, and the postoperative pain measured using a numeric rating scale was 0 to 1 from the first postoperative day.Lung cancer surgery using the da Vinci SP without intercostal sites was easy to perform and exhibited advantages in terms of postoperative pain and cosmetics.

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One-Year Clinical Experience of Single-Port and Multi-Port Robotic Thyroid Surgery in a Single Institution

Lee,

Hwang,

Shin

et al. 2024

JCM

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Background: With the advent of da Vinci SP, surgical methods using da Vinci SP are becoming popular in thyroid surgery. The authors previously reported on a new surgical method called the single-port robotic areolar (SPRA) approach, which evolved from the previous bilateral axillary breast approach (BABA). This paper reports a comparative analysis of SPRA and BABA over one year. Methods: The data on SPRA and BABA thyroid surgery performed at the authors’ hospital from December 2022 to December 2023 were analyzed. Results: 111 SPRA and 159 BABA surgeries were performed. SPRA was performed overwhelmingly on women (1 man vs. 110 women), and the body mass index (BMI) was lower in SPRA patients (23.63 ± 3.49 vs. 25.71 ± 4.39, p < 0.001). The proportion of total thyroidectomy was significantly higher in BABA patients, and a modified radical neck dissection (MRND) was only performed using the BABA method. The time for flap formation before robot docking was significantly shorter in SPRA patients (12.08 ± 3.99 vs. 18.34 ± 5.84 min, p < 0.001). Postoperative drain amount was also significantly lower in SPRA patients (53.87 ± 35.45 vs. 81.74 ± 30.26 mL, p < 0.001). Hospital stay after surgery was significantly shorter with SPRA (3.04 ± 0.48 vs. 3.36 ± 0.73 days, p < 0.001). Thyroglobulin levels after a total thyroidectomy (0.06 ± 0.13 vs. 0.45 ± 0.78, p = 0.002) and stimulated Tg level before the RAI (1.03 ± 0.74 vs. 5.01 ± 13.63, p = 0.046) were significantly lower in the SPRA group. No significant differences were observed between the two groups according to the postoperative complications, including vocal cord palsy and hypoparathyroidism. Conclusions: Based on the authors’ experience, SPRA is a less invasive robot thyroid surgery method than BABA.

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First Experience of Single-Port Robotic Areolar Approach Thyroidectomy

Cited by 4 publications

References 24 publications

Da Vinci single-port robotic system current application and future perspective in general surgery: A scoping review

Da Vinci single-port robotic system current application and future perspective in general surgery: A scoping review

Robotic pulmonary lobectomy without using intercostal sites: The first case of lung cancer surgery using the da Vinci SP surgical system in Japan

One-Year Clinical Experience of Single-Port and Multi-Port Robotic Thyroid Surgery in a Single Institution

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