Transaxillary gasless robotic thyroidectomy: a single surgeon's experience in North America

Area of Science:

• Surgical Innovation
• Minimally Invasive Surgery
• Endocrinology

Background:

• Conventional endoscopic thyroid surgery has limitations.
• Transaxillary approaches offer cosmetic benefits but can be challenging.
• Robotic assistance may enhance precision and overcome limitations.

Purpose of the Study:

• To describe a robotic transaxillary gasless thyroidectomy technique.
• To evaluate the feasibility, safety, and outcomes of this novel surgical approach.
• To incorporate intraoperative peripheral nerve monitoring.

Main Methods:

• Prospective study of 50 patients undergoing robotic transaxillary thyroidectomy.
• Inclusion of preoperative and postoperative direct laryngoscopy.
• Evaluation of demographic data, operative times, complications, and hospital stay.

Main Results:

• No conversions to open surgery; one transient radial nerve neuropathy.
• No vocal cord palsy or paresis; all patients discharged within 24 hours.
• Excellent cosmetic outcomes reported due to hidden incision placement.

Conclusions:

• Robotic transaxillary gasless thyroidectomy is feasible, safe, and effective.
• This technique overcomes limitations of conventional endoscopic thyroid surgery.
• This represents a novel approach for thyroid disease management in the US.