Advertisement

Indian Journal of Surgical Oncology

, Volume 9, Issue 4, pp 477–482 | Cite as

Feasibility, Safety, and Surgical Outcome of Robotic Hemithyroidectomy Via Transaxillary and Retroauricular Approach: an Institutional Experience

  • Surender Dabas
  • Karan GuptaEmail author
  • Yogendra Singh Bhakuni
  • Reetesh Ranjan
  • Himanshu Shukla
  • Ashwani Sharma
Original Article
  • 19 Downloads

Abstract

The aim of this observational prospective study was to determine the technical feasibility, safety, and adequacy of robotic hemithyroidectomy. From April 2015 to May 2016, 16 patients with solitary thyroid lesion underwent robotic hemithyroidectomy using the Da Vinci® Si Surgical system. Patients were observed and data were recorded on surgical time, blood loss, complications, and functional outcome of the patients. A total of 16 patients (3 males and 13 females; mean age 39.9 years) underwent robotic hemithyroidectomy after evaluation for solitary thyroid nodule with a mean nodule size of 2.2 ± 0.3 cm. Fiber-optic laryngoscopy (FOL) was normal in all cases pre-operatively. Five patients were operated by transaxillary approach, the rest by retroauricular (facelift) approach. Mean pocket dissection time was 42 min for transaxillary and 40 min for retroauricular approach. Mean operative console time was 59.4 min for transaxillary and 52.6 min for retroauricular approach. Average blood loss was 45 ml. Mean hospital stay was 1.5 days. None of the patients had any post-operative complication on follow-up. One patient had restricted left vocal cord mobility which improved in 3 months. Mean pain score was 0.25 ± 0.4 and average speech score was 0.5 ± 0.2 at 3 months. Post-operatively, all patients had adequate swallowing with no episode of aspiration. Robotic hemithyroidectomy is a safe, feasible, and oncologically safe procedure. It has benefits in terms of better scar cosmesis than open surgery.

Keywords

Robotic thyroidectomy Transaxillary Retroauricular Functional outcome 

References

  1. 1.
    Tae K, Ji YB, Jeong JH, Lee SH, Jeong MA, Park CW (2011) Robotic thyroidectomy by a gasless unilateral axillo-breast or axillary approach: our early experiences. Surg Endosc 25(1):221–228CrossRefGoogle Scholar
  2. 2.
    Kang SW, Lee SC, Lee SH et al (2009) Robot-assisted endoscopic surgery for thyroid cancer: experience with the first 100 patients. Sure Endosc 23(11):2399–2406CrossRefGoogle Scholar
  3. 3.
    Kang SW, Lee SC, Lee SH, Lee KY, Jeong JJ, Lee YS, Nam KH, Chang HS, Chung WY, Park CS (2009) Robot assisted endoscopic thyroidectomy for thyroid malignancies using a gas less transaxillary approach and the Da Vinci system: the operative outcome of 338 consecutive patients. Surgery 146(6):1048–1055CrossRefGoogle Scholar
  4. 4.
    Lee J, Yun JH, Nam KH, Soh EY, Chung WY (2011) The learning curve for robotic thyroidectomy: a multicentre study. Ann Surg Oncol 18(1):226–232CrossRefGoogle Scholar
  5. 5.
    Mercante G, Ruscito P, Pellini R (2013) TORS for tongue base tumours. Acta Otorhinoaryngol Ital 33(4):230–235Google Scholar
  6. 6.
    Bodian CA, Freedman G, Hossain S, Elsenkraft JB (2001) The visual analog scale for pain: clinical significance in postoperative patients. Anesthesiology 95(6):1356–1361CrossRefGoogle Scholar
  7. 7.
    Bhargava PRK, Kumbhar US, Satyam G, Gayathri KB (2013) Gasless single incision trans-axillary thyroidectomy: the feasibility and safety of a hypomorbid endoscopic thyroidectomy technique. J Minim Access Surg 9(3):118–121Google Scholar
  8. 8.
    Jackson NR, Yao L, Tufano RP, Kandil EH (2014) Safety of robotic thyroidectomy approaches: meta-analysis and systemic review. Head Neck 36(1):137–143CrossRefGoogle Scholar
  9. 9.
    Lee YM, Yi O, Sung TY, Chung KW, Yoon JH, Hong SJ (2014) Surgical outcomes of robotic thyroid surgery using a double incision gasless transaxillary approach: analysis of 400 patients treated by same surgeon. Head Neck 36(10):1413–1419PubMedGoogle Scholar
  10. 10.
    Kandil EH, Noureldine SI, Yao L, Slakey DP (2012) Robotic transaxillary thyroidectomy: an examination of the first one hundred cases. J Am Coll Surg 214(4):558–564CrossRefGoogle Scholar
  11. 11.
    Singer MC, Seybt MW, Terris DJ (2011) Robotic facelift thyroidectomy: I. Preclinical simulation and morphometric assessment. Laryngoscope 121(8):1631–1635CrossRefGoogle Scholar
  12. 12.
    Lee J, Na KY, Kim RM, Oh Y, Lee JH, Lee J, Lee JS, Kim CH, Soh EY, Chung WY (2012) Postoperative functional voice changes after conventional open or robotic thyroidectomy: a prospective trial. Ann Surg Oncol 19(9):2963–2970CrossRefGoogle Scholar
  13. 13.
    Kandil E, Saeed A, Mohamed SE, Alsaleh N, Aslam R (2015) Modified robotic-assisted thyroidectomy: an initial experience with the retroauricular approach. Laryngoscope 125(3):767–771CrossRefGoogle Scholar
  14. 14.
    Lee J, Yun JH, Nam KH, Choi UJ, Chung WY, Soh EY (2011) Perioperative clinical outcomes after robotic thyroidectomy for thyroid carcinoma: a multicenter study. Surg Endosc 25(3):906–912CrossRefGoogle Scholar
  15. 15.
    Lee J, Lee JH, Nah KY, Soh EY, Chung WY (2011) Comparison of endoscopic and robotic thyroidectomy. Ann Surg Oncol 18(5):1439–1446CrossRefGoogle Scholar
  16. 16.
    Noureldine SI, Jackson NR, Tufano RP, Kandil E (2013) A comparative North American experience of robotic thyroidectomy in a thyroid cancer population. Langenbeck's Arch Surg 398(8):1069–1074CrossRefGoogle Scholar
  17. 17.
    Somashekhar SP, Ashwin KR (2017) Robot-assisted thyroidectomy using a gasless, transaxillary approach for the management of thyroid lesions: Indian experience. J Minim Access Surg 13(4):280–285CrossRefGoogle Scholar
  18. 18.
    Thankappan K, Dabas S, Deshpande M (2017) Robotic retroauricular thyroidectomy: initial experience from India. Gland Surg 6(3):267–271CrossRefGoogle Scholar

Copyright information

© Indian Association of Surgical Oncology 2018

Authors and Affiliations

  1. 1.Department of Head-Neck and Thoracic Surgical OncologyFortis Memorial Research Institute (FMRI)GurugramIndia

Personalised recommendations