Transoral robotic thyroidectomy using Versius platform: a preclinical feasibility study in cadavers.

Area of Science:

• Robotic Surgery
• Surgical Oncology
• Head and Neck Surgery

Background:

• Conventional thyroidectomy causes cervical scarring, leading to interest in remote-access techniques.
• Transoral robotic thyroidectomy (TORT) offers scarless access but has been limited to specific platforms.
• The Versius robotic system is a novel platform for head and neck procedures.

Purpose of the Study:

• To assess the feasibility and safety of TORT using the Versius robotic system in human cadavers.
• To identify optimal robotic arm configurations for standardizing the procedure and minimizing collisions.
• To evaluate the potential benefits of a transaxillary fourth arm for enhanced surgical exposure.

Main Methods:

• Four fresh human cadavers underwent transoral robotic thyroidectomy using the Versius system.
• Various robotic arm configurations were systematically tested to find the optimal setup.
• Identification and preservation of critical structures like recurrent laryngeal nerves and parathyroid glands were assessed.

Main Results:

• Total thyroidectomy was successfully completed in all cadavers.
• An optimal configuration using C-shaped arms and a Z-shaped camera minimized instrument collisions.
• Recurrent laryngeal nerves and parathyroid glands were successfully identified and preserved.
• A transaxillary fourth arm improved surgical exposure.

Conclusions:

• The Versius robotic system is technically feasible for transoral thyroidectomy in cadaveric models.
• Standardized docking and arm configurations are crucial for collision avoidance.
• A transaxillary fourth arm shows promise for improving surgical exposure in TORT.
• Further clinical trials are needed to confirm safety and efficacy in live patients.