Endocrinol Metab.  2014 Sep;29(3):226-232. 10.3803/EnM.2014.29.3.226.

Can Robotic Thyroidectomy Be Performed Safely in Thyroid Carcinoma Patients?

Affiliations
  • 1Department of Surgery, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
  • 2Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea. kyu.eun.lee.md@gmail.com
  • 3Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Abstract

Since the adoption of the Da Vinci robotic system for remote access thyroid surgery, robotic thyroidectomy (RT) has become a popular surgical option for patients who want to avoid neck scars. Surgeons in South Korea pioneered this surgical technique and have reported successful outcomes. Although many studies have reported that RT is a feasible and safe therapeutic alternative, concerns over the surgical and oncological safety of RT remain. This article reviews the advantages and disadvantages of RT and compares the surgical safety and oncological completeness of RT with conventional open thyroidectomy.

Keyword

Thyroid neoplasms; Robotic thyroidectomy; Robot-assisted thyroidectomy; Transaxillary thyroidectomy; Bilateral axillo-breast approach

MeSH Terms

Cicatrix
Humans
Korea
Neck
Thyroid Gland
Thyroid Neoplasms*
Thyroidectomy*

Figure

  • Fig. 1 Patient position and flap dissection area (red color) of transaxillary approach (A) and bilateral axillo-breast approach (B).


Reference

1. Xing M. BRAF mutation in thyroid cancer. Endocr Relat Cancer. 2005; 12:245–262.
2. Kang SW, Jeong JJ, Nam KH, Chang HS, Chung WY, Park CS. Robot-assisted endoscopic thyroidectomy for thyroid malignancies using a gasless transaxillary approach. J Am Coll Surg. 2009; 209:e1–e7.
3. Lee KE, Choi JY, Youn YK. Bilateral axillo-breast approach robotic thyroidectomy. Surg Laparosc Endosc Percutan Tech. 2011; 21:230–236.
4. Lee KE, Kim E, Koo do H, Choi JY, Kim KH, Youn YK. Robotic thyroidectomy by bilateral axillo-breast approach: review of 1,026 cases and surgical completeness. Surg Endosc. 2013; 27:2955–2962.
5. Kang SW, Jeong JJ, Yun JS, Sung TY, Lee SC, Lee YS, Nam KH, Chang HS, Chung WY, Park CS. Robot-assisted endoscopic surgery for thyroid cancer: experience with the first 100 patients. Surg Endosc. 2009; 23:2399–2406.
6. Inabnet WB 3rd. Robotic thyroidectomy: must we drive a luxury sedan to arrive at our destination safely? Thyroid. 2012; 22:988–990.
7. Lee J, Nah KY, Kim RM, Ahn YH, Soh EY, Chung WY. Differences in postoperative outcomes, function, and cosmesis: open versus robotic thyroidectomy. Surg Endosc. 2010; 24:3186–3194.
8. Tae K, Ji YB, Cho SH, Lee SH, Kim DS, Kim TW. Early surgical outcomes of robotic thyroidectomy by a gasless unilateral axillo-breast or axillary approach for papillary thyroid carcinoma: 2 years' experience. Head Neck. 2012; 34:617–625.
9. Lee J, Kwon IS, Bae EH, Chung WY. Comparative analysis of oncological outcomes and quality of life after robotic versus conventional open thyroidectomy with modified radical neck dissection in patients with papillary thyroid carcinoma and lateral neck node metastases. J Clin Endocrinol Metab. 2013; 98:2701–2708.
10. Ryu HR, Lee J, Park JH, Kang SW, Jeong JJ, Hong JY, Chung WY. A comparison of postoperative pain after conventional open thyroidectomy and transaxillary single-incision robotic thyroidectomy: a prospective study. Ann Surg Oncol. 2013; 20:2279–2284.
11. Kim WW, Kim JS, Hur SM, Kim SH, Lee SK, Choi JH, Kim S, Lee JE, Kim JH, Nam SJ, Yang JH, Choe JH. Is robotic surgery superior to endoscopic and open surgeries in thyroid cancer? World J Surg. 2011; 35:779–784.
12. Landry CS, Grubbs EG, Warneke CL, Ormond M, Chua C, Lee JE, Perrier ND. Robot-assisted transaxillary thyroid surgery in the United States: is it comparable to open thyroid lobectomy? Ann Surg Oncol. 2012; 19:1269–1274.
13. Noureldine SI, Jackson NR, Tufano RP, Kandil E. A comparative North American experience of robotic thyroidectomy in a thyroid cancer population. Langenbecks Arch Surg. 2013; 398:1069–1074.
14. Kim BS, Kang KH, Kang H, Park SJ. Central neck dissection using a bilateral axillo-breast approach for robotic thyroidectomy: comparison with conventional open procedure after propensity score matching. Surg Laparosc Endosc Percutan Tech. 2014; 24:67–72.
15. Yoo H, Chae BJ, Park HS, Kim KH, Kim SH, Song BJ, Jung SS, Bae JS. Comparison of surgical outcomes between endoscopic and robotic thyroidectomy. J Surg Oncol. 2012; 105:705–708.
16. Kim HY, d'Ajello F, Woo SU, Son GS, Lee JB, Bae JW. Robotic thyroid surgery using bilateral axillo-breast approach: personal initial experience over two years. Minerva Chir. 2012; 67:39–48.
17. Yi O, Yoon JH, Lee YM, Sung TY, Chung KW, Kim TY, Kim WB, Shong YK, Ryu JS, Hong SJ. Technical and oncologic safety of robotic thyroid surgery. Ann Surg Oncol. 2013; 20:1927–1933.
18. Ban EJ, Yoo JY, Kim WW, Son HY, Park S, Lee SH, Lee CR, Kang SW, Jeong JJ, Nam KH, Chung WY, Park CS. Surgical complications after robotic thyroidectomy for thyroid carcinoma: a single center experience with 3,000 patients. Surg Endosc. 2014; Epub 2014 Mar 20. DOI: http://dx.doi.org/10.1007/s00464-014-3502-1.
19. Barczynski M, Konturek A, Pragacz K, Papier A, Stopa M, Nowak W. Intraoperative nerve monitoring can reduce prevalence of recurrent laryngeal nerve injury in thyroid reoperations: results of a retrospective cohort study. World J Surg. 2014; 38:599–606.
20. Kim SJ, Lee KE, Myong JP, Koo do H, Lee J, Youn YK. Prospective study of sensation in anterior chest areas before and after a bilateral axillo-breast approach for endoscopic/robotic thyroid surgery. World J Surg. 2013; 37:1147–1153.
21. Song CM, Ji YB, Bang HS, Park CW, Kim H, Tae K. Long-term sensory disturbance and discomfort after robotic thyroidectomy. World J Surg. 2014; 38:1743–1748.
22. Lee KE, Koo do H, Im HJ, Park SK, Choi JY, Paeng JC, Chung JK, Oh SK, Youn YK. Surgical completeness of bilateral axillo-breast approach robotic thyroidectomy: comparison with conventional open thyroidectomy after propensity score matching. Surgery. 2011; 150:1266–1274.
23. Lee S, Lee CR, Lee SC, Park S, Kim HY, Son H, Kang SW, Jeong JJ, Nam KH, Chung WY, Park CS, Cho A. Surgical completeness of robotic thyroidectomy: a prospective comparison with conventional open thyroidectomy in papillary thyroid carcinoma patients. Surg Endosc. 2014; 28:1068–1075.
24. Kwon H, Koo do H, Choi JY, Kim E, Lee KE, Youn YK. Bilateral axillo-breast approach robotic thyroidectomy for Graves' disease: an initial experience in a single institute. World J Surg. 2013; 37:1576–1581.
25. Noureldine SI, Yao L, Wavekar RR, Mohamed S, Kandil E. Thyroidectomy for Graves' disease: a feasibility study of the robotic transaxillary approach. ORL J Otorhinolaryngol Relat Spec. 2013; 75:350–356.
26. Kang SW, Lee SH, Ryu HR, Lee KY, Jeong JJ, Nam KH, Chung WY, Park CS. Initial experience with robot-assisted modified radical neck dissection for the management of thyroid carcinoma with lateral neck node metastasis. Surgery. 2010; 148:1214–1221.
27. Kim BS, Kang KH, Park SJ. Robotic modified radical neck dissection by bilateral axillary breast approach for papillary thyroid carcinoma with lateral neck metastasis. Head Neck. 2013; Epub 2013 Nov 8. DOI: http://dx.doi.org/10.1002/hed.23545.
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