What is robotic-assisted thyroidectomy?

Updated: May 08, 2018
  • Author: Neerav Goyal, MD, MPH; Chief Editor: Arlen D Meyers, MD, MBA  more...
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With the increasing prevalence of robotic surgery programs, more varied applications for the system have been described. To avoid a neck incision for thyroidectomy, transaxillary approaches have been described and is being used in some centers. As an extension of this approach, a transaxillary approach using the DaVinci robotic system was devised by Kang et al. Using a 4-6 cm axillary incision and an 8 mm medial skin incision, the surgeon introduces 4 robotic arms to perform the thyroidectomy and then follows the same steps as a conventional thyroidectomy. Although achieving a better cosmetic result without an incision on the neck, the technique is more invasive with a wider dissection necessary. A total thyroidectomy through a single sided transaxillary incision provides significant technical difficulties. With the significant expense of using a robotic system, the operation may be cost prohibitive. [31]

Another robot-assisted technique has been described more recently using a traditional postauricular rhytidectomy incision. This is described as a single-port technique and has been performed in appropriately selected patients (low body mass index, no previous neck surgery, no significant comorbidities). Terris et al described a case series with operative times ranging from 97-193 minutes and all but the first patient being performed on in an outpatient setting. [32]

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