Re-do Operation Using a Robotic System due to Locoregional Recurrence after Initial Thyroidectomy for Thyroid Cancer

Abstract

Locoregional recurrent thyroid cancer is commonly treated with re-do operation. This study aimed to investigate the feasibility of using robotic system for re-do operation in locoregional recurrent thyroid cancer. Sixty-five patients who underwent re-do robotic operation using trans-axillary approach for locoregional recurrent thyroid cancer from October 2007 to April 2021 at Yonsei University Hospital were analyzed. Completion total thyroidectomy (CTT) was performed in 26 cases, CTT and modified radical neck node dissection (mRND) in 16, and mRND in 23. Most of the re-do robotic operations were performed at site of previous incision. All patients were diagnosed with papillary thyroid carcinoma (PTC). CTT with central compartment neck dissection (CCND) took 117.6 ± 26.3 min, CTT with mRND 255.6 ± 38.6 min, and mRND, 211.7 ± 52.9 min. Transient hypocalcemia occurred in 17 (26.2%) patients and permanent hypocalcemia occurred in 3 (4.6%). There was one case of recurrent laryngeal nerve(RLN) injury. One patient was diagnosed with structural recurrence after re-do robotic operation. Median follow-up duration was 50.7 ± 37.1 months. Re-do robotic operation can be an alternative for patients who are diagnosed with locoregional recurrent thyroid cancer after thyroidectomy, with no increase in morbidity, similar oncologic outcomes, and superior cosmetic satisfaction.

Re-do transoral robotic thyroidectomy is feasible: preliminary results of the surgical feasibility and efficacy of completion transoral robotic thyroidectomy: cohort study

“…Despite the development and advancement of various remote-access thyroidectomy approaches, the feasibility of completion thyroidectomy has not been fully explored 26 . Only a limited number of studies, including case series and case reports, have described the surgical outcomes in patients undergoing completion thyroidectomy via remote-access surgery 14 , 15 , 27 – 30 . One study reported on the surgical outcomes of completion thyroidectomy via endoscopic bilateral axillo-breast approach for 13 patients 28 , while another study reported on the surgical outcomes of completion thyroidectomy via robotic bilateral axillo-breast approach for 33 patients 15 , both highlighting the safety and favourable cosmetic results of the procedure.…”

“…Despite reservations, patients who initially chose remote-access surgeries express a preference for the same approach in completion thyroidectomy, driven by persistent cosmetic concerns from the initial surgery, as observed in our experience. Previous reports have reported the feasibility of completing thyroidectomy through other remote-access approaches 14 , 15 . Building on our experience with TORT, we successfully performed ten completion TORT procedures.…”

Bibliometric analysis of research trends and hotspots on robot-assisted thyroid surgery

“…[ 24 , 25 ] Furthermore, postoperative pain and analgesic dosage show no significant increase, [ 26 ] contributing significantly to the increasing favorability of robot-assisted thyroid surgery among surgeons and patients with thyroid diseases. Professor CHUNG WY has also validated the feasibility and safety of robot-assisted thyroid surgery in patients with hyperthyroidism and locally recurrent thyroid cancer, [ 27 , 28 ] highlighting its suitability for various conditions like thyroid cancer, hyperthyroidism, and locally recurrent thyroid cancer. However, it crucial to note that these studies are based on patients from South Korea and may not universally represent all thyroid disease patients worldwide, lacking generalizability.…”

Expansion of thyroid surgical territory through 10,000 cases under the da Vinci robotic knife

“…Recently, many papers on robotic thyroid surgery have been published, including 500 cases of lateral neck dissection 27 , surgeries for recurrent cancer 28 , and Graves’ disease 25 , and papers focusing on the utilization of the da Vinci SP system 23 , 29 , 30 . These publications can be viewed as evidence of the expansion of indications.…”