Transoral Thyroidectomy Using A Flexible Robotic System: A Preclinical Cadaver Feasibility Study.

Area of Science:

• Minimally Invasive Surgery
• Robotic Surgery
• Head and Neck Surgery

Background:

• Traditional thyroid surgery leaves permanent neck scars.
• Minimally invasive and remote access techniques are evolving.
• Transoral approaches offer aesthetic advantages but have limitations with current technology.

Purpose of the Study:

• To evaluate the feasibility of a novel flexible robotic system for transvestibular thyroidectomy.
• To assess the system's ability to perform thyroid lobectomies in a preclinical cadaver model.
• To explore improvements in visualization and instrument maneuverability for transoral thyroid surgery.

Main Methods:

• A preclinical feasibility study was conducted using four cadavers.
• Right and left thyroid lobectomies were performed via a transvestibular approach.
• A novel flexible robotic system with a 3D camera and wristed instruments was utilized.

Main Results:

• Successful right and left thyroid lobectomies were completed in all four cadavers.
• The flexible robot entered the subplatysmal plane through a single vestibular incision.
• Recurrent laryngeal nerves and parathyroids were identified and preserved with excellent visualization and precise instrument control.

Conclusions:

• The transoral vestibular approach using the flexible robotic system is feasible for thyroidectomy.
• This technique provides optimal cosmetic results by avoiding cutaneous incisions.
• The novel flexible robotic system enhances visualization and access, potentially improving the application of transoral thyroid surgery.