Preclinical Simulation of Transoral Robotic Thyroidectomy Using a Training Box and the Versius Robotic Platform

Transoral robotic thyroidectomy (TORT) represents an alternative to open surgery, offering favorable cosmetic outcomes and comparable oncologic results. However, standardized training pathways and validated simulation models replicating standardized setups for emerging robotic platforms remain limited. An experimental simulation of total thyroidectomy and central (recurrent) neck dissection was performed with the Versius robotic system in a validated synthetic training box. Optimal robotic positioning and docking were determined, and a standardized procedural sequence was followed to ensure optimal results. Simulation was successful only with a C-shaped configuration of the robotic arms and a posteriorly positioned camera in a Z-shaped layout, matching prior cadaveric findings. All thyroidectomy steps proceeded smoothly. However, during central neck dissection, instrument collisions limited access to deeper spaces, restricting maneuverability. The training box allowed successful simulation of TORT with the Versius system in this proof-of-concept study, providing a platform for evaluating robotic positioning and docking configurations and supporting further investigation of its potential applications in training and preclinical assessment.