Robotic thyroidectomy: Evolution and Outcomes

Abstract

Recently robotic thyroidectomy has gained its popularity for the treatment of differentiated thyroid cancer and benign thyroid tumors. It has been developed to overcome the drawbacks of conventional open trans-cervical thyroidectomy, which is an apparent neck wound that is visible unless concealed with clothes. Robotic thyroidectomy provides surgeons with three-dimensional magnified view and multiarticulated robotic arms that can stabilize hand tremors. It also has advantages over conventional trans-cervical thyroidectomy that include recovery of voice symptoms and acoustic parameters along with superior cosmetic outcomes. Robotic thyroidectomy results in equivalent surgical outcomes including oncologic safety and complications compared with conventional thyroidectomy. Various approaches including transaxillary, postauricular facelift, and breast-axillary approaches have been developed for robotic thyroidectomy. Recently, the indication of robotic surgery has been extended to neck dissection of the lateral compartment. Herein we summarize the indication, procedures, and efficacy of robotic thyroidectomy, and also introduce our experience with robotic thyroidectomy.

Intraoperative neuromonitoring of the RLNs during TOETVA procedures

“…Natural orifice transluminal endoscopic surgery (NOTES) for thyroidectomy was developed. First endoscopic thyroidectomy described in 1997 (1) and first transoral thyroidectomy was cited as a novel means of procedure to be utilized for minimally invasive thyroid resection by Witzell et al (2). Transoral endoscopic thyroidectomy by vestibular approach (TOETVA) is a promising procedure with many advantages such as truly scar free healing, minimally invasive dissection, and accessible approach to both thyroid lobes (3).…”

Carbon dioxide embolism during transoral robotic thyroidectomy: A case report

“…Endoscopic and robotic thyroidectomies have been gaining in popularity since the first endoscopic thyroidectomy in 1997 . It is considered a feasible procedure that results in better postoperative cosmetic outcomes than conventional transcervical thyroidectomy .…”

“…It is considered a feasible procedure that results in better postoperative cosmetic outcomes than conventional transcervical thyroidectomy . Endoscopic and robotic thyroidectomies can be classified depending on the site of incision into cervical, axillary, breast, anterior chest, postauricular facelift, and transoral approaches . It can also be classified into the gasless method, and the carbon dioxide (CO 2 ) insufflation method, according to the use of CO 2 gas.…”

“…Endoscopic and robotic thyroidectomies have been gaining in popularity since the first endoscopic thyroidectomy in 1997. 1 It is considered a feasible procedure that results in better postoperative cosmetic outcomes than conventional transcervical thyroidectomy. 2 Endoscopic and robotic thyroidectomies can be classified depending on the site of incision into cervical, axillary, breast, anterior chest, postauricular facelift, and transoral approaches.…”

Transoral Robotic Thyroidectomy: Description of the Surgical Technique in the Cadaveric Model

“…Although this technique is safe, it has a disadvantage of a visible scar. First endoscopic thyroidectomy described in 1997 (2). Since this time there have been a great number of endoscopic and remote-access approaches to the neck described to minimize the cervical scar.…”