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Langenbeck's Archives of Surgery

, Volume 403, Issue 7, pp 891–896 | Cite as

Surgery for Graves’ disease in the era of robotic-assisted surgery: a study of safety and feasibility in the Western population

  • Meghan Garstka
  • Emad KandilEmail author
  • Lachin Saparova
  • Maroun Bechara
  • Rebecca Green
  • Antoine B. Haddad
  • Sang-Wook Kang
  • Patrick Aidan
ORIGINAL ARTICLE

Abstract

Purpose

Thyroid surgery for Graves’ disease is known to be associated with higher risk of complications. We seek to compare outcomes between robotic-assisted and open cervical approach thyroid surgery in patients with Graves’ disease in the Western population.

Methods

We performed a retrospective cohort study using prospectively collected databases for patients undergoing robotic-assisted or conventional cervical approach thyroid surgery for Graves’ disease at two academic medical centers, one in North America (New Orleans, LA) and one in Europe (Paris, France).

Results

A total of 102 patients were included, of which 56 (55%) underwent robotic thyroidectomy and 46 (45%) underwent conventional open cervical thyroidectomy. Mean age was 40.2 ± 13.2 years and 94 (92%) were females. Mean BMI for the sample was 27.7 ± 10.2 kg/m2. There was a trend towards larger specimen volume in the robotic-assisted group, 84.9 ± 62.2 cm3 versus 65.2 ± 40.5 cm3 (p = 0.07). Mean length of stay for the French patients undergoing robotic-assisted surgery was 3.2 ± 0.5 days. For the American cohort, length of stay was significantly shorter for robotic-assisted thyroidectomy, at 0.8 ± 0.4 days versus 1.0 ± 0.2 days (p = 0.003). Operative time was longer in patients who underwent robotic thyroidectomy (174.4 ± 33.5 min) compared to patients who underwent traditional cervical approach (121.2 ± 41.1 min, p < 0.0001). There was no difference in complication rates for the overall sample of patients undergoing robotic-assisted or open cervical procedures.

Conclusion

Robotic thyroid surgery is safe in a select group of patients with Graves’ disease in the Western population. Additional studies are warranted to further investigate these findings.

Keywords

Graves’ disease Robotic-assisted surgery Surgical outcomes Hyperthyroidism 

Notes

Acknowledgements

The authors would like to thank Loula Burton of Tulane University for her assistance with proofreading of this manuscript.

Authors’ contributions

• Study conception and design—Garstka, Kandil, Saparova, Bechara, Green, Haddad, Kang, Aidan.

• Acquisition of data—Garstka, Kandil, Saparova, Bechara, Green, Haddad, Kang, Aidan.

• Analysis and interpretation of data—Garstka, Kandil, Saparova, Bechara, Green, Haddad, Kang, Aidan.

• Drafting of manuscript—Garstka, Kandil, Saparova, Kang, Aidan.

• Critical revision of manuscript—Garstka, Kandil, Saparova.

Funding

There are no funding sources to disclose.

Compliance with ethical standards

Conflict of interest

Dr. Patrick Aidan is a proctor in robotic thyroid surgery for Intuitive Surgical. All other authors have no potential conflicts of interest to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

References

  1. 1.
    Liu ZW, Masterson L, Fish B, Jani P, Chatterjee K (2015) Thyroid surgery for Graves' disease and Graves' ophthalmopathy. Cochrane Database Syst Rev 11:CD010576Google Scholar
  2. 2.
    Genovese BM, Noureldine SI, Gleeson EM, Tufano RP, Kandil E (2013) What is the best definitive treatment for Graves' disease?. A systematic review of the existing literature. Ann Surg Oncol 20(2):660–667CrossRefGoogle Scholar
  3. 3.
    Giannopoulos G, Kang SW, Jeong JJ, Nam KH, Chung WY (2013) Robotic thyroidectomy for benign thyroid diseases: a stepwise strategy to the adoption of robotic thyroidectomy (gasless, transaxillary approach). Surg Laparosc Endosc Percutan Tech 23(3):312–315CrossRefGoogle Scholar
  4. 4.
    Kandil E, Noureldine SI, Abbas A, Tufano RP (2013) The impact of surgical volume on patient outcomes following thyroid surgery. Surgery 154(6):1346–1352 discussion 1352-3CrossRefGoogle Scholar
  5. 5.
    Kandil E, Noureldine S, Abdel Khalek M, Alrasheedi S, Aslam R, Friedlander P, Holsinger FC, Bellows CF (2011) Initial experience using robot- assisted transaxillary thyroidectomy for Graves' disease. J Visc Surg 148(6):e447–e451CrossRefGoogle Scholar
  6. 6.
    Noureldine SI, Yao L, Wavekar RR, Mohamed S, Kandil E (2013) Thyroidectomy for Graves' disease: a feasibility study of the robotic transaxillary approach. ORL J Otorhinolaryngol Relat Spec 75(6):350–356CrossRefGoogle Scholar
  7. 7.
    Aidan P, Pickburn H, Monpeyssen H, Boccara G (2013) Indications for the gasless transaxillary robotic approach to thyroid surgery: experience of forty-seven procedures at the American Hospital of Paris. Eur Thyroid J 2(2):102–109CrossRefGoogle Scholar
  8. 8.
    Kim MJ, Nam KH, Lee SG, Choi JB, Kim TH, Lee CR, Lee J, Kang SW, Jeong JJ, Chung WY (2018) Yonsei experience of 5000 gasless Transaxillary robotic thyroidectomies. World J Surg 42(2):393–401CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Meghan Garstka
    • 1
  • Emad Kandil
    • 1
    Email author
  • Lachin Saparova
    • 1
  • Maroun Bechara
    • 2
  • Rebecca Green
    • 1
  • Antoine B. Haddad
    • 1
  • Sang-Wook Kang
    • 1
  • Patrick Aidan
    • 2
  1. 1.Department of SurgeryTulane University School of MedicineNew OrleansUSA
  2. 2.American Hospital of ParisParisFrance

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