BACKGROUND: Our objective was to evaluate the anatomic basis for robotic-assisted transaxillary thyroidectomy and to determine its feasibility in a prospective clinical trial. METHODS AND RESULTS: Using the da Vinci Surgical Robotic System, we performed 5 cadaveric dissections, via transaxillary approach without gas insufflation. Once the safety and feasibility of this approach had been demonstrated in cadavers, it was utilized to perform a thyroid lobectomy in a patient. The da Vinci system provided excellent visualization of the recurrent and superior laryngeal nerves, parathyroid glands, and paratracheal lymphatics. After the 5 cadaver dissections, the procedure time diminished from >90 minutes to <30 minutes. CONCLUSION: Robotic-assisted transaxillary thyroidectomy is feasible with proper instrumentation and an understanding of the surgical anatomy. Based on this preclinical laboratory study and our experience in 1 patient, further evaluation of this approach in the setting of a prospective clinical trial is warranted to determine standardized criteria identifying patients who would benefit from this approach.
BACKGROUND: Our objective was to evaluate the anatomic basis for robotic-assisted transaxillary thyroidectomy and to determine its feasibility in a prospective clinical trial. METHODS AND RESULTS: Using the da Vinci Surgical Robotic System, we performed 5 cadaveric dissections, via transaxillary approach without gas insufflation. Once the safety and feasibility of this approach had been demonstrated in cadavers, it was utilized to perform a thyroid lobectomy in a patient. The da Vinci system provided excellent visualization of the recurrent and superior laryngeal nerves, parathyroid glands, and paratracheal lymphatics. After the 5 cadaver dissections, the procedure time diminished from >90 minutes to <30 minutes. CONCLUSION: Robotic-assisted transaxillary thyroidectomy is feasible with proper instrumentation and an understanding of the surgical anatomy. Based on this preclinical laboratory study and our experience in 1 patient, further evaluation of this approach in the setting of a prospective clinical trial is warranted to determine standardized criteria identifying patients who would benefit from this approach.
Authors: Sang-Wook Kang; So Hee Lee; Jae Hyun Park; Jun Soo Jeong; Seulkee Park; Cho Rok Lee; Jong Ju Jeong; Kee-Hyun Nam; Woong Youn Chung; Cheong Soo Park Journal: Surg Endosc Date: 2012-05-31 Impact factor: 4.584
Authors: Giorgos Papaspyrou; Alfio Ferlito; Carl E Silver; Jochen A Werner; Eric Genden; Andreas M Sesterhenn Journal: Surg Endosc Date: 2010-09-16 Impact factor: 4.584
Authors: Seo Ki Kim; Jung-Woo Woo; Inhye Park; Jun Ho Lee; Jun-Ho Choe; Jung-Han Kim; Jee Soo Kim Journal: Langenbecks Arch Surg Date: 2016-10-24 Impact factor: 3.445