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Rambam Maimonides Med J. 2014 Apr 28;5(2):e0013. doi: 10.5041/RMMJ.10147. eCollection 2014 Apr.

Robot-assisted transaxillary thyroid surgery-feasibility and safety of a novel technique.

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Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petach Tikva, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of ENT Head and Neck surgery, The American Hospital, Paris, France.


Developments in technology have led to a rapid progress in robotic endocrine surgery applications. With the advent of minimally invasive techniques in thyroid surgery, robot-assisted transaxillary thyroid surgery (RATS) has emerged as one of the most promising approaches. Its main advantages are improved cosmetic outcome, avoiding cervical incisions, thereby increasing patient satisfaction, and improved visualization, arms articulations, and precision, resulting in fewer surgical complications. The main disadvantages are potential new injuries to the brachial plexus, esophagus, and trachea, longer operative time, and increased cost compared to conventional thyroidectomy. In skilled hands, RATS is a safe alternative to conservative thyroidectomy and should be presented to patients with aesthetic concerns. As with any new emerging technique, careful patient selection is crucial, and further evidence must be sought to confirm its indications over time.


Robot; thyroidectomy; transaxillary

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