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Robotic transaxillary endocrine surgery: a comparison with conventional open technique.

Christina S Foley1, Orhan Agcaoglu, Allan E Siperstein

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Robotic transaxillary endocrine surgery for thyroid and parathyroid conditions is safe and effective, with outcomes comparable to open procedures. Surgeons experienced a learning curve, leading to longer initial operating times but no increased complications.

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Area of Science:

  • Endocrine Surgery
  • Minimally Invasive Surgery
  • Robotic Surgery

Background:

  • Robotic transaxillary (RT) endocrine surgery offers potential cosmetic benefits.
  • Initial experience with RT thyroid and parathyroid surgery is reported.
  • Comparison to open thyroidectomy (OT) and focal parathyroidectomy (FP) is made.

Purpose of the Study:

  • To evaluate the initial experience and learning curve of robotic transaxillary endocrine surgery.
  • To compare early surgical outcomes of RT procedures with traditional open surgery.
  • To assess the safety and efficacy of RT thyroid and parathyroidectomy.

Main Methods:

  • Prospective database review of patients undergoing RT endocrine surgery.
  • Case-matched comparison group of patients undergoing OT or FP.
  • Statistical comparison using Student's t test and the χ(2) test for demographics, outcomes, and complications.

Main Results:

  • Fifteen RT procedures (11 thyroidectomies, 4 parathyroidectomies) were performed.
  • No significant differences in demographics, pathology, or complications between RT and open groups.
  • RT procedures had longer mean operating times and incision lengths, but operating time decreased with experience.

Conclusions:

  • Robotic transaxillary thyroidectomy and parathyroidectomy are safely performed by specialist endocrine surgeons.
  • Early learning curve for RT endocrine surgery shows no increased complication rate.
  • While operating times are longer, RT surgery is a viable option with potential cosmetic advantages.