Robotic thyroid surgery: current perspectives and future considerations
File(s)
Author(s)
Aidan, P
Arora, A
Lorincz, B
Tolley, N
Garas, G
Type
Journal Article
Abstract
Robotic transaxillary thyroidectomy, pioneered in South Korea, is firmly established throughout the Far East but remains controversial in Western practice. This relates to important population differences (anthropometry and culture) compounded by the smaller mean size of thyroid nodules operated on in South Korea due to a national thyroid cancer screening programme. There is now level 2 evidence (including from Western World centres) to support the safety, feasibility, and equivalence of the robotic approach to its open counterpart in terms of recurrent laryngeal nerve injury, hypoparathyroidism, haemorrhage, and oncological outcomes for differentiated thyroid cancer. Moreover, robotic thyroidectomy has been shown to be superior to open surgery for certain patient-reported outcome measures, namely scar cosmesis and pain. Downsides include its high cost, longer operative time, and risk of complications not encountered in open thyroidectomy (brachial plexus neurapraxia). Careful patient selection is paramount as this procedure is not for every patient, surgeon, or hospital. It should only be undertaken by high-volume surgeons operating as part of a multidisciplinary robotic team in specialised centres. Novel robotic approaches utilising the retroauricular and transoral routes for thyroidectomy have recently been described but further studies are required to establish their respective role in modern thyroid surgery.
Date Issued
2018-11-01
Date Acceptance
2018-03-12
ISSN
0301-1569
Publisher
Karger Publishers
Start Page
186
End Page
194
Journal / Book Title
ORL-Journal for Oto-Rhino-Laryngology Head and Neck Surgery
Volume
80
Issue
3-4
Copyright Statement
© 2018 S. Karger AG, Basel
Source Database
pubmed
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/29788019
000488354
Subjects
Science & Technology
Life Sciences & Biomedicine
Otorhinolaryngology
Robotic surgery
Thyroid
Axillary approach
Retroauricular approach
Facelift
Transoral route
Evidence
Safety
Cosmesis
Policy
CONVENTIONAL OPEN THYROIDECTOMY
TRANSAXILLARY THYROIDECTOMIES
ENDOSCOPIC THYROIDECTOMY
OPEN PARATHYROIDECTOMY
POSTOPERATIVE PAIN
AXILLO-BREAST
METAANALYSIS
CANCER
EXPERIENCE
SAFETY
Axillary approach
Cosmesis
Evidence
Facelift
Policy
Retroauricular approach
Robotic surgery
Safety
Thyroid
Transoral route
Axillary approach
Cosmesis
Evidence
Facelift
Policy
Retroauricular approach
Robotic surgery
Safety
Thyroid
Transoral route
Otorhinolaryngology
Publication Status
Published
Country
Switzerland
Date Publish Online
2018-05-22