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A comparison of surgical outcomes between endoscopic and robotically assisted thyroidectomy: the authors' initial
Brian Hung-Hin Lang1, Man-Po Chow
1Department of Surgery, The University of Hong Kong, Hong Kong SAR, China. blang@hkucc.hku.hk
Surgical Endoscopy
|November 20, 2010
Summary
Robot-assisted thyroidectomy (RAT) offers no significant benefits over gasless, transaxillary endoscopic thyroidectomy (GTET), despite longer procedure times and increased initial pain. However, RAT did improve recurrent laryngeal nerve identification and eliminated the need for surgical assistants.
Area of Science:
- Minimally Invasive Surgery
- Surgical Technology
- Endocrine Surgery
Background:
- Gasless, transaxillary endoscopic thyroidectomy (GTET) provides a scarless neck approach.
- Robotically assisted thyroidectomy (RAT) was developed to enhance GTET ergonomics and outcomes.
- The comparative benefits of RAT over GTET remain under investigation.
Purpose of the Study:
- To compare the outcomes of robotically assisted thyroidectomy (RAT) with gasless, transaxillary endoscopic thyroidectomy (GTET).
- To evaluate the impact of robotic assistance on surgical efficiency and patient recovery.
Main Methods:
- A comparative study of 46 patients undergoing endoscopic thyroidectomy from June to December 2009.
- 39 patients underwent GTET, while 7 patients underwent RAT using the da Vinci S robotic system.
- Demographics, surgical indications, operative findings, and postoperative outcomes were analyzed after a minimum 6-month follow-up.
Main Results:
- Procedure time was significantly longer for RAT (149 min) compared to GTET (100 min).
- Contralateral recurrent laryngeal nerve identification was higher in RAT (100%) than GTET (42.9%).
- RAT eliminated the need for surgical assistants, unlike GTET which required one on average. Postoperative pain was higher on day 0 for RAT but similar by day 1. Blood loss, hospital stay, and complications were comparable.
Conclusions:
- The addition of the da Vinci S robot to GTET extended procedure time and increased immediate postoperative pain.
- RAT demonstrated an advantage in recurrent laryngeal nerve identification and obviated the need for surgical assistants.
- In early experience, RAT did not show clear benefits over GTET despite improved nerve visualization.
