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Robotic-assisted parathyroidectomy via transaxillary approach: feasibility and learning curves
Emad Kandil1, Deena Hadedeya1, Mahmoud Shalaby1
1Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA.
Gland Surgery
|April 12, 2021
Summary
Robotic-assisted transaxillary parathyroidectomy is safe and effective for primary hyperparathyroidism (PHPT). Proficiency is achieved in under 15 cases, demonstrating feasibility for select patients.
Area of Science:
- Minimally Invasive Surgery
- Endocrine Surgery
- Robotic Surgery
Background:
- Robotic-assisted transaxillary parathyroidectomy is infrequently reported.
- This study details the experience with this technique in Western populations.
Purpose of the Study:
- To report the experience with robotic-assisted transaxillary parathyroidectomy for primary hyperparathyroidism (PHPT).
- To analyze the learning curve for this surgical approach.
Main Methods:
- Retrospective study of 102 patients undergoing robotic-assisted transaxillary parathyroidectomy between 2010 and 2019.
- Data collected included demographics, perioperative details, and outcomes.
- A linear regression model assessed the learning curve for surgeons at two institutions.
Main Results:
- The study included 102 patients (80.4% female, median age 55.6 years).
- Median operative time was 116 minutes, with a low complication rate (1.96%).
- Surgeons achieved proficiency by the 8th and 14th cases, respectively; disease recurrence was minimal.
Conclusions:
- This is the largest series of robotic-assisted transaxillary parathyroidectomy for PHPT in Asian and Western patients.
- Proficiency is gained rapidly, typically within 15 surgeries.
- The procedure is safe and feasible for select patients with localized disease when performed by experienced surgeons.
