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

Abstract

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.