Robotic versus Endoscopic Thyroidectomy for Thyroid Cancers: A Multi-Institutional Analysis of Early Postoperative Outcomes and Surgical Learning Curves

Lee, Jandee; Yun, Jong Ho; Choi, Un Jong; Kang, Sang–Wook; Jeong, Jong Ju; Chung, Woong Youn

doi:10.1155/2012/734541

Cited by 55 publications

(65 citation statements)

References 20 publications

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“…In a comparative study by Lee et al (29), the superiority of robotic thyroidectomy to endoscopic thyroidectomy in terms of operative time, lymph node dissection, and learning curve was described. For both procedures, the operative time was found to decrease gradually with increasing experience and reach a steady state after 35-40 cases for robotic thyroidectomy, and 55-60 cases for endoscopic thyroidectomy (29). In another prospective multicenter study, outcomes of robotic total or subtotal thyroidectomy were compared between one experienced and three inexperienced robotic thyroid surgeons.…”

Section: The Learning Curvementioning

confidence: 99%

American Thyroid Association Statement on Remote-Access Thyroid Surgery

Berber

Bernet

Fahey

et al. 2016

Thyroid

208

179

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Background: Remote-access techniques have been described over the recent years as a method of removing the thyroid gland without an incision in the neck. However, there is confusion related to the number of techniques available and the ideal patient selection criteria for a given technique. The aims of this review were to develop a simple classification of these approaches, describe the optimal patient selection criteria, evaluate the outcomes objectively, and define the barriers to adoption. Methods: A review of the literature was performed to identify the described techniques. A simple classification was developed. Technical details, outcomes, and the learning curve were described. Expert opinion consensus was formulated regarding recommendations for patient selection and performance of remote-access thyroid surgery. Results: Remote-access thyroid procedures can be categorized into endoscopic or robotic breast, bilateral axillobreast, axillary, and facelift approaches. The experience in the United States involves the latter two techniques. The limited data in the literature suggest long operative times, a steep learning curve, and higher costs with remote-access thyroid surgery compared with conventional thyroidectomy. Nevertheless, a consensus was reached that, in appropriate hands, it can be a viable option for patients with unilateral small nodules who wish to avoid a neck incision. Conclusions: Remote-access thyroidectomy has a role in a small group of patients who fit strict selection criteria. These approaches require an additional level of expertise, and therefore should be done by surgeons performing a high volume of thyroid and robotic surgery.

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Section: The Learning Curvementioning

confidence: 99%

American Thyroid Association Statement on Remote-Access Thyroid Surgery

Berber

Bernet

Fahey

et al. 2016

Thyroid

208

179

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“…During robotic surgery, the LNs may be optimally dissected by a traction/countertraction technique. Indeed, large case series and comparative analyses have shown greater surgical completeness and radicality using robotic than using conventional open or endoscopic methods [16,17,21,22,24,25,26,27]. …”

Section: Oncologic Outcomes and Safety After Robotic Surgerymentioning

confidence: 99%

Robotic Surgery for Thyroid Disease

Lee¹,

Chung²

2013

Eur Thyroid J

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Robotic surgery is an innovation in thyroid surgery that may compensate for the drawbacks of conventional endoscopic surgery. A surgical robot provides strong advantages, including three-dimensional imaging, motion scaling, tremor elimination, and additional degrees of freedom. We review here recent adaptations, experience and applications of robotics in thyroid surgery. Robotic thyroid surgeries include thyroid lobectomy, total thyroidectomy, central compartment neck dissection, and radical neck dissection for benign and malignant thyroid diseases. Most of the current literature consists of case series of robotic thyroidectomies. Recent retrospective and prospective analyses have evaluated the safety and oncologic efficacy of robotic surgery for thyroid cancer. Although robotic thyroid surgery is often associated with longer operation times than conventional open surgery, robotic techniques have shown similar or superior levels of surgical completeness and safety compared with conventional open or endoscopic surgery. Compared to open thyroidectomy, robotic thyroidectomy has been associated with several quality-of-life benefits, including excellent cosmetic results, reduced neck pain and sensory changes, and decreased voice and swallowing discomfort after surgery. For surgeons, robotic surgery has improved ergonomics and has a shorter learning curve than open or endoscopic surgery. The advantages of robotic thyroid surgery over conventional surgery suggest that robotic thyroidectomy with or without neck dissection may become the preferred surgical option for thyroid diseases. Robotic thyroid surgery will likely continue to develop as more endocrine and head-and-neck surgeons are trained and more patients seek this newly developed surgical option.

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“…A few years earlier, a large case series of robotic thyroidectomy for cancer had precisely shown that the robotic approach has decreased operative times and improved lymph node yields compared to the endoscopic technique. Moreover, the robotic learning curve was shorter [76]. A large case series of 100 patients with papillary thyroid microcarcinoma was published and reported on the robotic total thyroidectomy with central node dissection while compared to the open approach.…”

Section: Endocrine Surgery: Robotics In Unusual Placesmentioning

confidence: 99%

The Surgical Robot: Applications and Advantages in General Surgery

Barrera¹

2018

Surgical Robotics

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The field of General Surgery with its multiple sub-specialties has experienced the progression of minimally invasive procedures performed with the robotic technology since the last decade. The robotic applications are extensive and have contributed to the enrichment of the surgical sub-specialties based on advantages such as increased surgeon control and autonomy, superior instrument dexterity and tissue handling, improved three-dimensional visualization, wristed articulation, all of this despite the lack of haptic feedback. The sub-specialties of Colorectal, Hepatobiliary and Pancreatic, Gastric Oncologic, Bariatric, Foregut, Pediatric, Endocrine, and Hernia Surgery, in addition to General Surgery as the principal specialty, have produced several high-quality randomized controlled trials, meta-analyses, prospective and retrospective series which have established, in many instances, superior results to those of laparoscopy, and at least non-inferior outcomes over the years. From the first pioneer single-surgeon experiences around the world to the most recent large trials, including the first Robotic General Surgery case series in an American community hospital not classified as a tertiary referral center, patients continue to benefit from this technology as surgeons engage in overcoming their learning curve and training their teams, involving their hospital administrators and working with the industry to perfect their techniques for the sake of their patients.

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Robotic versus Endoscopic Thyroidectomy for Thyroid Cancers: A Multi-Institutional Analysis of Early Postoperative Outcomes and Surgical Learning Curves

Cited by 55 publications

References 20 publications

American Thyroid Association Statement on Remote-Access Thyroid Surgery

American Thyroid Association Statement on Remote-Access Thyroid Surgery

Robotic Surgery for Thyroid Disease

The Surgical Robot: Applications and Advantages in General Surgery

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