Robot-Assisted Transaxillary Thyroid Surgery: As Safe as Conventional-Access Thyroid Surgery?

Dralle, Henning

doi:10.1159/000350856

Cited by 19 publications

(10 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Despite its low incidence of 0.2%, brachial plexus injury is nonetheless a very significant and worrying complication that patients should be informed of prior to seeking informed consent. Fortunately, not only is it rare, but also transient, being associated with the “traditional” transaxillary approach [36, 37]. The risk has now been considerably reduced since arm positioning was modified from the original technique described by Chung et al [8] to the “extended salute position” [1, 26].…”

Section: Drawbacksmentioning

confidence: 99%

Robotic Thyroid Surgery: Current Perspectives and Future Considerations

Aïdan

Arora

Lőrincz

et al. 2018

ORL

View full text Add to dashboard Cite

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.

show abstract

Section: Drawbacksmentioning

confidence: 99%

Robotic Thyroid Surgery: Current Perspectives and Future Considerations

Aïdan

Arora

Lőrincz

et al. 2018

ORL

View full text Add to dashboard Cite

show abstract

“…Concerns furthermore involve new and severe complications not known in open thyroid surgery like brachial plexus neuropathy and tracheal injury, as well as quality control regarding recurrent laryngeal nerve palsy and hypoparathyroidism, moreover adequacy of oncological outcome in thyroid cancer. While longer procedural time is accepted in the learning curve, immense cost expenditure and considerate complication rates are highly controversial [8]. Even though the procedure and cosmetic outcome are elegant, propagation of robotic thyroidectomy in Europe struggles with expenditure in costs, time, learning curve, constitution, and missing oncological outcome and follow-up data.…”

Section: Robotic Thyroidectomymentioning

confidence: 99%

The European Society of Endocrine Surgeons perspective of thyroid cancer surgery: an evidence-based approach

Lorenz

Niederle

Steinmüller

et al. 2014

Langenbecks Arch Surg

Self Cite

View full text Add to dashboard Cite

During the last two decades, thyroid cancer surgery has dramatically changed due to the rising incidence of small papillary thyroid cancers, the identification of RET proto-oncogene mutations causing hereditary thyroid cancer, the introduction of minimally invasive procedures including scarless neck surgery, and the acknowledgement of BRAF mutation as a promising diagnostic element for presurgical diagnosis of papillary thyroid cancer. The European Society of Endocrine Surgeons (ESES) Workshop 2013 on "Thyroid Cancer Surgery" in Berlin was aimed to summarize and discuss the aforementioned recent developments concerning their conceptual consequences for the diagnosis and surgical approach to thyroid cancer. The design of the workshop was basically evidence based. The presentations of major sessions were thoroughly prepared ahead to the meeting by a group of responsible authors each. Final manuscripts published in this issue of the Langenbeck's Archives of Surgery (1-6, 9-11) are representing the conclusion of pre-workshop electronic versions and discussions by the ESES members' assembly throughout the sessions of the congress. Timing and extent of surgery for gene carriers of hereditary C-cell diseaseBased on the current evidence of hereditary medullary thyroid cancer (MTC), the assembly agreed that tailoring surgery according to the genotype of RET proto-oncogene mutation, age, and calcitonin level appears superior to fixed risks groups based on the genotype and age only [1]. For a true prophylactic thyroidectomy in asymptomatic gene carriers of hereditary C-cell disease, the basal calcitonin level is of utmost importance. Most recent studies have convincingly shown that C-cell-derived MTC is confined to the thyroid gland unless basal calcitonin level exceeds the upper normal range.In order to individualize the optimum time for prophylactic thyroidectomy and to minimize surgical morbidity, in particular permanent postoperative hypoparathyroidism, asymptomatic gene carriers of hereditary C-cell disease should be prepared for parathyroid-preserving prophylactic thyroidectomy independent of age and genotype but based on basal calcitonin levels. The best time for curative prophylactic thyroidectomy is when basal calcitonin levels are approaching the upper normal range. Due to the rarity of the disease and the surgical challenges of performing thyroidectomy in the pediatric age, only highly specialized thyroid surgeons should perform prophylactic thyroidectomies in children. Multifocal papillary thyroid cancerMultifocal papillary thyroid cancer (PTC) is a unique subtype of PTC concerning its controversial pathogenesis from intrathyroidal spread of primarily unifocal PTC or multifocal synchronous de novo lesions of PTC [2]. Apart from underlying risk factors like previous external irradiation of the neck or familial non-medullary thyroid cancer, there is no general consensus regarding the frequency of regional lymph node metastases of multifocal PTC compared to unifocal PTC of the same tumor size. The role for prophyl...

show abstract

“…B. Insulinome und hormoninaktive neuroendokrine Pankreastumoren; [2]), für andere aber auch trotz erwiesener technischer Machbarkeit nicht ohne Kontroverse (z. B. Roboter-assistierte transaxilläre Schilddrüsenresek-tion; [3]). Die Autoren haben mit der vorliegenden Studie zur transoralen Parathyreoidektomie (TOP) ein weiteres, überaus kontroverses Thema aufgegriffen und kommen aufgrund ihrer Ergebnisse zu eindeutigen Schlussfolgerungen.…”

Section: Hintergrund Und Fragestellungunclassified

Transorale Parathyreoidektomie

Dralle

2014

Chirurg

View full text Add to dashboard Cite

show abstract

Robot-Assisted Transaxillary Thyroid Surgery: As Safe as Conventional-Access Thyroid Surgery?

Cited by 19 publications

References 53 publications

Robotic Thyroid Surgery: Current Perspectives and Future Considerations

Robotic Thyroid Surgery: Current Perspectives and Future Considerations

The European Society of Endocrine Surgeons perspective of thyroid cancer surgery: an evidence-based approach

Transorale Parathyreoidektomie

Contact Info

Product

Resources

About