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Robotic Thyroid Surgery: Current Perspectives and Future Considerations.

Patrick Aidan1, Asit Arora2, Balazs Lorincz3

  • 1Department of Otorhinolaryngology and Head and Neck Surgery, American Hospital of Paris, Paris, France.

ORL; Journal for Oto-Rhino-Laryngology and Its Related Specialties
|May 23, 2018
PubMed
Summary
This summary is machine-generated.

Robotic transaxillary thyroidectomy offers comparable safety and oncological outcomes to open surgery, with improved patient satisfaction regarding scars and pain. Careful patient selection and specialized teams are crucial for its successful implementation.

Keywords:
Axillary approachCosmesisEvidenceFaceliftPolicyRetroauricular approachRobotic surgerySafetyThyroidTransoral route

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Area of Science:

  • Minimally Invasive Surgery
  • Surgical Oncology
  • Robotic Surgery

Background:

  • Robotic transaxillary thyroidectomy (RT) is widely adopted in East Asia but faces challenges in Western countries.
  • Population differences and variations in thyroid nodule size (due to screening programs) contribute to this disparity.
  • Evidence is emerging to support RT's safety and efficacy.

Observation:

  • Level 2 evidence from Western centers supports RT's safety and feasibility compared to open thyroidectomy.
  • No significant differences were observed in recurrent laryngeal nerve injury, hypoparathyroidism, hemorrhage, or oncological outcomes.
  • Patient-reported outcomes show RT is superior for scar cosmesis and pain management.

Findings:

  • RT demonstrates equivalence to open thyroidectomy for critical safety and oncological parameters.
  • RT offers significant advantages in patient-reported outcomes, specifically cosmetic satisfaction and reduced pain.
  • Potential downsides include higher costs, longer operative times, and specific complications like brachial plexus neurapraxia.

Implications:

  • Careful patient selection is essential for successful RT, as it is not universally applicable.
  • High-volume surgeons, multidisciplinary teams, and specialized centers are prerequisites for RT implementation.
  • Emerging robotic approaches (retroauricular, transoral) require further investigation to define their role in thyroid surgery.