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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma

Published on: September 15, 2023

New technique using the snake retractor for complete lymph node dissection in robotic thyroid surgery: initial

Wan W Kim¹, Jin H Jung, Ho Y Park

¹Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Korea. kww1324@naver.com

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques

|February 7, 2013

Summary

A novel snake retractor technique improves central lymph node dissection (CND) during robotic thyroid surgery. This method enhances visualization and increases harvested lymph nodes for better papillary thyroid cancer treatment.

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Area of Science:

Surgical Oncology
Minimally Invasive Surgery
Robotic Surgery

Background:

Robotic thyroid surgery using bilateral axillo-breast approaches offers cosmetic advantages but can present visualization challenges.
Central lymph node dissection (CND) is crucial for accurate staging and treatment of papillary thyroid cancer.
Optimal visualization is essential for safe and effective CND during robotic procedures.

Purpose of the Study:

To introduce and evaluate a new technique using a snake retractor for enhanced visualization during robotic thyroid surgery.
To assess the impact of the snake retractor on the completeness of central lymph node dissection (CND).
To compare the outcomes of robotic thyroidectomy with and without the snake retractor for CND.

Main Methods:

A retrospective analysis of 58 patients with papillary thyroid cancer undergoing robotic thyroidectomy.
Comparison between 20 patients without a snake retractor and 38 patients with a snake retractor for CND.
All patients underwent ipsilateral CNDs; data on lymph node yield and complications were collected.

Main Results:

The mean number of harvested lymph nodes was significantly higher with the snake retractor (7.9) compared to without (5.3) (P = 0.04).
Postoperative complication rates, including transient hypocalcemia and recurrent laryngeal nerve palsy, were low in both groups.
Serum thyroglobulin levels showed no significant difference between the groups.

Conclusions:

The snake retractor facilitates safe and effective central lymph node dissection in robotic thyroid surgery.
This technique provides a superior view, enabling simultaneous use of two robotic arms for improved CND.
The use of a snake retractor enhances the quality of CND in robotic thyroidectomy via bilateral axillo-breast approaches.