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Robotic neck surgery using retroauricular approach - Experience of 60 procedures
Antonio Augusto Bertelli1, Bruno Vallim Monazzi2, Thaís Tuasca Jareño3
1Head and Neck Surgery Division, Department of Surgery - Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil. dr.bertelli@me.com.
Journal of Robotic Surgery
|October 27, 2025
Summary
Retroauricular robotic neck surgery offers a cosmetic alternative to traditional incisions. This study found the approach safe, feasible, and oncologically effective, with outcomes comparable to conventional methods.
Area of Science:
- Surgical Oncology
- Robotic Surgery
- Head and Neck Surgery
Background:
- Conventional cervical incisions for neck surgery raise cosmetic concerns.
- Remote access techniques are gaining traction but require validation of safety and oncologic outcomes.
Purpose of the Study:
- To evaluate the safety, feasibility, and oncologic effectiveness of retroauricular robotic neck surgery.
- To compare outcomes with conventional surgical approaches.
Main Methods:
- Retrospective analysis of 32 patients undergoing 60 retroauricular robotic procedures using the Da Vinci system.
- Data included demographics, procedure types (neck dissections, thyroidectomies), and oncologic follow-up.
- Analysis of complication rates, hospital stay, lymph node yield, and regional control.
Main Results:
- The study included 20 patients with malignant disease (62.5%).
- Median hospital stay was 2 days, comparable to conventional surgery.
- Complication rates were low (temporary nerve palsies, lymphatic fistula, hypoparathyroidism, flap necrosis), with one hematoma requiring reoperation.
- Three-year regional control rate was 94.7% in malignant cases.
- Conversion to conventional approach occurred in 6.7% of cases.
Conclusions:
- Retroauricular robotic neck surgery is a safe and feasible approach.
- The technique demonstrates comparable oncologic outcomes, complication rates, and hospital stay to conventional surgery.
- This approach provides a viable alternative for patients concerned about cosmetic outcomes.
