Transaxillary Gasless Robotic Thyroidectomy&lt;subtitle&gt;A Single Surgeon's Experience in North America&lt;/subtitle&gt;

Kandil, Emad

doi:10.1001/archoto.2011.1082

Cited by 38 publications

(39 citation statements)

References 23 publications

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“…Patients with a substernal or retropharyngeal goiter and lesions in the dorsal thyroid area near to the tracheo-oesophageal groove [12,14,15,26,27,28,29,30] were excluded from previous studies [16], suggesting that careful patient selection in terms of anatomical lesion location is paramount to successful outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Extrathyroidal involvement [12,14,15,20,26,27,29,30,31,32,33], multiple lateral lymph node involvement [12,14,15,27,28,29,30,34], perinodal involvement at metastatic lymph nodes [12,14,15,20,27,28,29,30,34] and distant metastatic disease [12,14,26,27,28,29,30,31,32,33] have all been cited as exclusion criteria for studies (online suppl. table 2).…”

Section: Discussionmentioning

confidence: 99%

“…Patient characteristics have been used as exclusion criteria for this procedure in both benign and malignant disease include thyroiditis, as both a definite and relative contraindication [32,33], severe [12,14,15,27,29] or advanced Graves' disease [16,26] and a history of neck surgery [12,14,15,16,26,27,29]. Graves' disease, however, has since been shown to be a valid indication for the technique [23].…”

Section: Discussionmentioning

confidence: 99%

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Indications for the Gasless Transaxillary Robotic Approach to Thyroid Surgery: Experience of Forty-Seven Procedures at the American Hospital of Paris

Aïdan¹,

Pickburn²,

Monpeyssen³

et al. 2013

Eur Thyroid J

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Background: Thyroid surgery is in a state of evolution from traditional open approaches to novel robotic techniques. The gasless transaxillary approach to thyroid surgery is effective in the management of thyroid cancer, and complications after robotic thyroidectomy are no higher than experienced after open or endoscopic techniques. The transaxillary robotic approach also avoids an anterior neck scar. This paper presents what the authors believe to be the largest cohort of patients reported in Europe undergoing gasless transaxillary robotic thyroid surgery, with the aim of defining the indications for this procedure. Methods: Forty-six patients underwent robotic thyroid surgery via the transaxillary approach and were enrolled in this study between March 2010 and September 2012. All patients were operated on by one surgeon at one clinical center. Reviewed data included patient characteristics, pathological characteristics, extent of surgery and postoperative complications. The mean follow-up time was 7.29 months. Results: Forty-six patients underwent 47 procedures, the average age of the patients was 43 years and the male to female ratio was 1:22. Undertaken were 30 lobectomies, 3 subtotal thyroidectomies, 13 total thyroidectomies and 1 totalization. One case was converted to an open procedure. The ratio of malignant to benign disease was 1:6.67 (6:40 cases) and analysis of the surgical specimens showed 6 follicular lesions, 24 follicular adenomas, 3 colloid lesions, 1 case of thyroiditis/lymphatic lesion, 3 adenomatoid lesions, 3 oncocytic adenomas, 3 papillary cancers and 3 microcapillary cancers. The overall average size of an individual specimen removed was 45.40 ± 28.95 cm³ (range 5-160, n = 47) and the average largest diameter of the lesion removed was 3.72 ± 0.95 cm (range 1.4-6.0, n = 47). Postoperatively, there were 5 recurrent laryngeal nerve injuries (4 transient), 2 transient brachial plexopathies, 1 case of postoperative dysphagia and 1 of collection of blood at the site of surgery. There were no cases of disease recurrence at follow-up. Conclusions: The gasless robotic transaxillary approach to thyroid surgery has been predicted to become a standard technique. It has been shown to be efficacious in the management of thyroid cancer with lateral neck metastases; however, more data relating to oncological safety in long-term follow-up is required. This intervention is also appropriate for benign thyroid disease including Graves' disease. To achieve consistently successful results, careful patient selection is fundamental in terms of patient characteristics and the anatomical aspects of the lesion. This is especially important with a geographical expansion to include North America and Europe. The excellent cosmetic results of this procedure make it ideal for patients who have esthetic concerns regarding particular difficulties with healing; however, in common with all new surgical procedures, further evidence must be sought to confirm its indications over time.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Indications for the Gasless Transaxillary Robotic Approach to Thyroid Surgery: Experience of Forty-Seven Procedures at the American Hospital of Paris

Aïdan¹,

Pickburn²,

Monpeyssen³

et al. 2013

Eur Thyroid J

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“…Patients were followed up between 4 and 6 weeks to examine thyroid function tests. We have previously described our technique of robotic thyroidectomy using a gasless transaxillary approach in detail [16,17]. …”

Section: Methodsmentioning

confidence: 99%

Thyroidectomy for Graves' Disease: A Feasibility Study of the Robotic Transaxillary Approach

Noureldine

Lu²,

Wavekar

et al. 2013

ORL

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Introduction: Graves' disease (GD) is considered a relative contraindication for endoscopic approaches to the thyroid gland, due to a larger gland size and increased vascularity. Methods: A retrospective analysis of a single surgeon's experience was performed. We included all patients who underwent thyroidectomy for the treatment of GD over a 3-year period. Results: Twenty-five patients with GD were identified. Twelve of them underwent robotic thyroidectomy and 13 patients underwent conventional thyroidectomy. Age, gender, and BMI were similar in both groups (p > 0.05). The conventional approach allowed for resection of larger thyroid volumes (147.3 ± 153.6 ml), as compared to the robotic approach (62.3 ± 47.8 ml, p = 0.08). The average total operative times were similar in both groups (p = 0.98). There was no difference with respect to intraoperative blood loss (p = 0.49), duration of hospital stay (p = 0.38), and complication rates (p = 0.99). Conclusion: Robotic thyroidectomy is feasible and can be safely performed in appropriately selected patients with GD.

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“…Kang et al [9], from the Yonsei University College of Medicine in Seoul (South Korea), were the first to describe RATS in 2009. Within a 5-year period, a total of 10,000 RATS procedures (without being able to avoid double counting of procedures reported by the same group in more than 1 publication) have been described in about 31 publications [4,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39]. Thirteen publications performed a head-to-head comparison of RATS and CATS [4,9,11,12,16,18,19,23,29,33,40,41,42].…”

Section: Tablementioning

confidence: 99%

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

Dralle

2013

Eur Thyroid J

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Transaxillary Gasless Robotic Thyroidectomy<subtitle>A Single Surgeon's Experience in North America</subtitle>

Cited by 38 publications

References 23 publications

Indications for the Gasless Transaxillary Robotic Approach to Thyroid Surgery: Experience of Forty-Seven Procedures at the American Hospital of Paris

Indications for the Gasless Transaxillary Robotic Approach to Thyroid Surgery: Experience of Forty-Seven Procedures at the American Hospital of Paris

Thyroidectomy for Graves' Disease: A Feasibility Study of the Robotic Transaxillary Approach

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

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