Skip to main content
Log in

Cosmetic Result and Overall Satisfaction after Minimally Invasive Video-assisted Thyroidectomy (MIVAT) versus Robot-assisted Transaxillary Thyroidectomy (RATT): A Prospective Randomized Study

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

No studies have compared robot-assisted transaxillary thyroidectomy (RATT) and minimally invasive video-assisted thyroidectomy (MIVAT) regarding cosmetic outcome and satisfaction

Methods

Patients matching the inclusion criteria (benign nodule less than 4 cm and thyroid volume less than 30 mL) were randomly allotted to undergo MIVAT (group A) or RATT (group B). Cosmetic result, overall satisfaction, operative time, and complications were evaluated.

Results

A total of 62 patients underwent hemithyroidectomy (30 in group A and 32 in group B). All patients were women, with the exception of one man in each group. The mean patient age was 36.9 years (group A) and 32.5 years (group B). Total operative time (intubation–extubation) was shorter in group A (71.6 min) than in group B (120.4 min). Complications included one transient laryngeal nerve injury in each group and one subcutaneous hematoma in group B. Postoperative hospital stay was longer in group B (1.85 days) than in group A (1.15 days). On the PASQ questionnaire, “scar appearance” and “satisfaction with appearance” scores were better in group A than in group B. In the Short Form (SF-36) 36-Item Health Survey Questionnaire, domains of “social activity” and “general health” were better in group B than in group A, whereas “bodily pain” scored higher in group B than in group A.

Conclusions

RATT seems not to supersede MIVAT in terms of satisfaction when comparing two groups of patients undergoing thyroidectomy for benign disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Gagner M (1996) Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism. Br J Surg 83:875

    Article  CAS  PubMed  Google Scholar 

  2. Ikeda Y, Takami H, Niimi M et al (2002) Endoscopic thyroidectomy and parathyroidectomy by the axillary approach. A preliminary report. Surg Endosc 16:92–95

    Article  CAS  PubMed  Google Scholar 

  3. Yoon JH, Park CH, Chung WY (2006) Gasless endoscopic thyroidectomy via an axillary approach: experience of 30 cases. Surg Laparosc Endosc Percutan Tech 16:226–231

    Article  PubMed  Google Scholar 

  4. Ohgami M, Ishii S, Arisawa Y et al (2000) Scarless endoscopic thyroidectomy: breast approach for better cosmesis. Surg Laparosc Endosc Percutan Tech 10:1–4

    CAS  PubMed  Google Scholar 

  5. Cho YU, Park IJ, Choi KH et al (2007) Gasless endoscopic thyroidectomy via an anterior chest wall approach using a flap-lifting system. Yonsei Med J 48:480–487

    Article  PubMed Central  PubMed  Google Scholar 

  6. Bärlehner E, Benhidjeb T (2007) Cervical scarless endoscopic thyroidectomy: axillo-bilateral-breast approach (ABBA). Surg Endosc 22:154–157

    Article  PubMed  Google Scholar 

  7. Choe JH, Kim SW, Chung KW et al (2007) Endoscopic thyroidectomy using a new bilateral axillo-breast approach. World J Surg 31:601–606. doi:10.1007/s00268-006-0481-y

    Article  PubMed  Google Scholar 

  8. Shan YZ, Zhou LM, Yu ZF et al (2012) Comparison between transareola single site endoscopic thyroidectomy and minimally invasive video-assisted thyroidectomy. J Int Med Res 40:2213–2219

    Article  PubMed  Google Scholar 

  9. Ikeda Y, Takami H, Sasaki Y et al (2003) Clinical benefits in endoscopic thyroidectomy by the axillary approach. J Am Coll Surg 196:189–195

    Article  PubMed  Google Scholar 

  10. Ikeda Y, Takami H, Sasaki Y et al (2002) Comparative study of thyroidectomies. Endoscopic surgery versus conventional open surgery. Surg Endosc 16:1741–1745

    Article  CAS  PubMed  Google Scholar 

  11. Ikeda Y, Takami H, Sasaki Y et al (2004) Are there significant benefits of minimally invasive endoscopic thyroidectomy? World J Surg 28:1075–1078. doi:10.1007/s00268-004-7655-2

    Article  PubMed  Google Scholar 

  12. Chung YS, Choe JH, Kang KH et al (2007) Endoscopic thyroidectomy for thyroid malignancies: comparison with conventional open thyroidectomy. World J Surg 31:2302–2308. doi:10.1007/s00268-007-9117-0

    Article  PubMed  Google Scholar 

  13. Kang SW, Jeong JJ, Yun JS et al (2009) Gasless endoscopic thyroidectomy using transaxillary approach: surgical outcome of 581 patients. Endocr J 56:361–369

    Article  PubMed  Google Scholar 

  14. Ikeda Y, Takami H, Sasaki Y et al (2000) Endoscopic neck surgery by axillary approach. J Am Coll Surg 191:336–340

    Article  CAS  PubMed  Google Scholar 

  15. Miccoli P, Berti P, Conte M et al (1999) Minimally invasive surgery for small thyroid nodules: preliminary report. J Endocrinol Invest 22:849–851

    Article  CAS  PubMed  Google Scholar 

  16. Terris DJ, Angelos P, Steward DL et al (2008) Minimally invasive video assisted thyroidectomy: a multiinstitutional North American experience. Arch Otolaryngol Head Neck Surg 134:81–84

    Article  PubMed  Google Scholar 

  17. Minuto MN, Berti P, Miccoli M et al (2012) Minimally invasive video-assisted thyroidectomy: an analysis of results and a revision of indications. Surg Endosc 26:818–822

    Article  PubMed  Google Scholar 

  18. Radford PD, Ferguson MS, Magill JC et al (2011) Meta-analysis of minimally invasive video-assisted thyroidectomy. Laryngoscope 121:1675–1681

    Article  PubMed  Google Scholar 

  19. Byrd JK, Nguyen SA, Ketcham A et al (2010) Minimally invasive video-assisted thyroidectomy versus conventional thyroidectomy: a cost-effective analysis. Otolaryngol Head Neck Surg 143:789–794

    Article  PubMed  Google Scholar 

  20. Miccoli P, Rago R, Massi M et al (2010) Standard versus video-assisted thyroidectomy: objective postoperative pain evaluation. Surg Endosc 24:2415–2417

    Article  PubMed  Google Scholar 

  21. Miccoli P, Materazzi G, Berti P (2010) Minimally invasive thyroidectomy in the treatment of well differentiated thyroid cancers: indications and limits. Curr Opin Otolaryngol Head Neck Surg 18:114–118

    Article  PubMed  Google Scholar 

  22. Miccoli P, Pinchera A, Materazzi G et al (2009) Surgical treatment of low-and intermediate-risk papillary thyroid cancer with minimally invasive video-assisted thyroidectomy. J Clin Endocrinol Metab 94:1618–1622

    Article  CAS  PubMed  Google Scholar 

  23. Miccoli P, Minuto MN, Ugolini C et al (2008) Minimally invasive video-assisted thyroidectomy for benign thyroid disease: an evidence-based review. World J Surg 32:1333–1340. doi:10.1007/s00268-008-9479-y

    Article  PubMed  Google Scholar 

  24. Miccoli P, Materazzi G (2004) Minimally invasive, video-assisted thyroidectomy (MIVAT). Surg Clin North Am 84:735–741

    Article  PubMed  Google Scholar 

  25. Miccoli P, Berti P, Raffaelli M et al (2001) Comparison between minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: a prospective randomized study. Surgery 130:1039–1043

    Article  CAS  PubMed  Google Scholar 

  26. Kang SW, Lee SC, Lee SH et al (2009) Robotic thyroid surgery using a gasless, transaxillary approach and the da Vinci S system: the operative outcomes of 338 consecutive patients. Surgery 146:1048–1055

    Article  PubMed  Google Scholar 

  27. Kang SW, Jeong JJ, Nam KH et al (2009) Robot-assisted endoscopic thyroidectomy for thyroid malignancies using a gasless transaxillary approach. J Am Coll Surg 209:1–7

    Article  Google Scholar 

  28. Lee J, Chung WY (2013) Robotic thyroidectomy and neck dissection: past present and future. Cancer J 19:151–161

    Article  PubMed  Google Scholar 

  29. Jackson NR, Yao L, Tufano RP et al (2014) Safety of robotic thyroidectomy approaches: meta-analysis and systematic review. Head Neck 36:137–143

    Article  PubMed  Google Scholar 

  30. Yi O, Yoon JH, Lee YM et al (2013) Technical and oncologic safety of robotic thyroid surgery. Ann Surg Oncol 20:1927–1933

    Article  PubMed  Google Scholar 

  31. Aliyev S, Taskin HE, Agcaoglu O et al (2013) Robotic transaxillary total thyroidectomy through a single axillary incision. Surgery 153:705–710

    Article  PubMed  Google Scholar 

  32. Chung WY (2012) Pros of robotic transaxillary thyroid surgery: its impact on cancer control and surgical quality. Thyroid 22:986–987

    Article  PubMed  Google Scholar 

  33. Terris DJ, Singer MC (2012) Robotic facelift thyroidectomy: facilitating remote access surgery. Head Neck 34:746–747

    Article  PubMed  Google Scholar 

  34. Broome JT, Pomeroy S, Solorzano CC (2012) Expense of robotic thyroidectomy: a cost analysis at a single institution. Arch Surg 147:1102–1106

    Article  PubMed  Google Scholar 

  35. Inabnet WB 3rd (2012) Robotic thyroidectomy: must we drive a luxury sedan to arrive at our destination safely? Thyroid 22:988–990

    Article  PubMed  Google Scholar 

  36. Cabot JC, Lee CR, Brunaud L et al (2012) Robotic and endoscopic transaxillary thyroidectomies may be cost prohibitive when compared to standard cervical thyroidectomy: a cost analysis. Surgery 152:1016–1024

    Article  PubMed  Google Scholar 

  37. Economopoulos KP, Petralias A, Linos E et al (2012) Psychometric evaluation of Patient Scar Assessment Questionnaire following thyroid and parathyroid surgery. Thyroid 22:145–150

    Article  PubMed  Google Scholar 

  38. Linos D, Economopoulos KP, Kiriakopoulos A et al (2013) Scar perceptions after thyroid and parathyroid surgery: comparison of minimal and conventional approaches. Surgery 153:400–407

    Article  PubMed  Google Scholar 

  39. Sahm M, Schwarz B, Schmidt S et al (2011) Long-term cosmetic result after minimally invasive video-assisted thyroidectomy. Surg Endosc 25:3202–3208

    Article  PubMed  Google Scholar 

  40. Bellantone R, Lombardi CP, Bossola M et al (2002) Video-assisted vs conventional thyroid lobectomy: a randomized trial. Arch Surg 137:301–304

    Article  PubMed  Google Scholar 

  41. Garratt A, Schmidt L, Mackintosh A et al (2002) Quality of life measurement: bibliographic study of patient assessed health outcome measures (Review). BMJ 324(7351):1417

    Article  PubMed Central  PubMed  Google Scholar 

  42. Lee J, Nah KY, Kim RM et al (2010) Differences in postoperative outcomes, function, and cosmesis: open versus robotic thyroidectomy. Surg Endosc 24:3186–3194

    Article  PubMed  Google Scholar 

  43. Tae K, Kim KY, Yun BR et al (2012) Functional voice and swallowing outcomes after robotic thyroidectomy by a gasless unilateral axillo-breast approach: comparison with open thyroidectomy. Surg Endosc 26:1871–1877

    Article  PubMed  Google Scholar 

  44. Tae K, Ji YB, Jeong JH et al (2011) Robotic thyroidectomy by a gasless unilateral axillo-breast or axillary approach: our early experiences. Surg Endosc 25:221–228

    Article  PubMed  Google Scholar 

  45. Perier N (2012) Why I have abandoned robot assisted transaxillary thyroid surgery. Surgery 152:1025–1026

    Article  Google Scholar 

  46. Duh QY (2011) Robot assisted endoscopic thyroidectomy: has the time come to abandon neck incisions? Ann Surg 253:1067–1068

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gabriele Materazzi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Materazzi, G., Fregoli, L., Manzini, G. et al. Cosmetic Result and Overall Satisfaction after Minimally Invasive Video-assisted Thyroidectomy (MIVAT) versus Robot-assisted Transaxillary Thyroidectomy (RATT): A Prospective Randomized Study. World J Surg 38, 1282–1288 (2014). https://doi.org/10.1007/s00268-014-2483-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-014-2483-5

Keywords

Navigation