OBJECTIVES: Robotic thyroidectomy and lymph node dissection is rapidly emerging as an alternative to conventional endoscopic thyroidectomy for thyroid carcinoma. Robot techniques incorporate the advantages of endoscopic procedures while overcoming some of the problems. We present the largest multi-institution clinical study of robotic thyroidectomy for thyroid carcinomas. The robotic thyroidectomy involved gasless transaxillary approach using the da Vinci surgical robot system.
METHODS: We reviewed a database of 1,043 consecutive patients with low-risk differentiated thyroid carcinoma who underwent robotic thyroidectomy between October 2007 and August 2009. Operations were performed by five surgeons at four academic centers. We analyzed perioperative, clinical, and pathological data.
RESULTS: The study involved 71 men and 972 women, with a mean age of 39 (range, 15-70) years. All operations were performed successfully without any need for conventional open or endoscopic conversion. There were 366 total thyroidectomies and 677 subtotal thyroidectomies with cervical lymph node dissection. The mean overall operation time and console time were 132.4 and 63.9 min, respectively. There were ten (1%) major postoperative morbidities. The mean tumor size was 0.8 (range, 0.1-6.0) cm, and the mean number of retrieved central lymph nodes was 5.1 ± 3.8 (range, 0-26). The mean postoperative hospital stay was 2.9 (range, 1-8) days.
CONCLUSIONS: Robotic thyroidectomy using gasless transaxillary method was feasible, safe, and provided good outcomes for patients with differentiated thyroid carcinoma. Robotic technology overcame some technical limitations associated with conventional endoscopy.
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