Abstract
Background
Differentiated thyroid carcinoma with lateral neck lymph node metastasis requires aggressive operative intervention, including lateral neck dissection. Although several robotic approaches have made precise surgery for thyroid cancer possible, few centers have expanded the technique for application to lateral neck dissections. This study aimed to demonstrate the technical feasibility, cosmetic effectiveness, and safety of robotic transaxillary lateral neck dissection (RTLND) using the da Vinci system.
Methods
From January 2008 to July 2019, 500 patients diagnosed with thyroid cancer with lateral neck node metastasis underwent RTLND. The clinicopathologic characteristics and surgical outcomes were retrospectively reviewed.
Results
All operations were performed successfully without open conversion. As the primary operation for thyroid cancer, 476 (95.2%) patients underwent unilateral or bilateral RTLND, including robotic total thyroidectomy. The remaining 24 patients (4.8%), all of whom had a recurrence, also underwent RTLND with additional procedures, if needed. The mean operation time for the 500 operations was 293.71 ± 67.22 min. Only five cases had recurrence and required further treatment.
Conclusions
RTLND is technically feasible and safe through the precise manipulation of robotic instruments. While this method is thorough and provides safe and effective surgical outcomes, it also offers the additional advantage of being minimally invasive.
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Acknowledgements
The authors thank the Severance Robot team, especially Ho Young Kim and Hee Chang Yu, for their technical support.
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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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Drs. Jin Kyong Kim MD, Cho Rok Lee MD, Sang-Wook Kang MD, PhD, Jong Ju Jeong MD, Kee-Hyun Nam MD, PhD, and Woong Youn Chung MD, PhD have no conflicts of interest or financial ties to disclose.
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Kim, J.K., Lee, C.R., Kang, SW. et al. Robotic transaxillary lateral neck dissection for thyroid cancer: learning experience from 500 cases. Surg Endosc 36, 2436–2444 (2022). https://doi.org/10.1007/s00464-021-08526-7
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DOI: https://doi.org/10.1007/s00464-021-08526-7