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J Laparoendosc Adv Surg Tech A. 2012 May;22(4):387-91. doi: 10.1089/lap.2010.0380. Epub 2012 Apr 10.

Robotic thyroidectomy: an initial experience with the gasless transaxillary approach.

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  • 1Division of General, Minimally Invasive, and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, Chicago, Illinois 60612, USA. piercg@uic.edu

Abstract

BACKGROUND:

Thyroid surgery has recently emerged as one of the most promising fields for the application of robotic surgery. We report the results of the first year of experience with a gasless transaxillary thyroidectomy.

SUBJECTS AND METHODS:

From January 2009 to December 2009, 10 consecutive patients (8 women) underwent robotic thyroidectomy through a gasless transaxillary approach. The median age was 44 years (range, 27-42 years). Eight total and two partial thyroidectomies (one left and one right) were performed using the da Vinci(®) Robotic Surgical System (Intuitive Surgical, Sunnyvale, CA). Preoperative diagnosis included solitary nodules with a median size of 16±11 mm (range, 3-44 mm) at preoperative imaging.

RESULTS:

All procedures were successfully completed robotically, except one that was converted because of difficulty in achieving an optimal exposure. The overall mean operative time was 177.4±40 minutes (range, 120-240 minutes) with minimal blood loss (<10 mL). Pathological diagnoses included papillary carcinoma (n=6), colloid nodule (n=2), and multinodular goiter (n=2). The mean number of lymph nodes harvested in the cases of malignant disease was 4±5 (range, 3-15). The median postoperative length of stay was 1.05 days (range, 1-1.4 days).

CONCLUSIONS:

Thyroid surgery using a gasless transaxillary approach can be performed safely for selected benign and malignant pathology. This approach offers superior cosmetic results and a short hospital stay over conventional thyroid surgery. For selected patients, this technique offers a promising scarless option for minimally invasive thyroid surgery.

PMID:
22489907
[PubMed - indexed for MEDLINE]
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