David J Terris1, Michael C Singer. 1. Department of Otolaryngology-Head and Neck Surgery, Georgia Health Sciences University, Augusta, Georgia 30912-4060, USA. dterris@georgiahealth.edu
Abstract
OBJECTIVES: Two distinct remote access robotic thyroidectomy techniques were implemented in a high-volume endocrine surgery practice. Important technical and clinical differences were observed and are described. STUDY DESIGN: Cross-sectional study with planned data collection. SETTING: Thyroid center. SUBJECTS AND METHODS: A panel of demographic and clinical parameters was captured in a series of patients undergoing 1 of 2 robotic thyroidectomy techniques (robotic axillary thyroidectomy [RAT] or robotic facelift thyroidectomy [RFT]). Particular attention was paid to time of surgery, ease of dissection, complications, use of drains, and length of stay. RESULTS: Fifteen robotic hemithyroidectomies were accomplished by either RAT (n = 5) or RFT (n = 10). The duration of surgery for RAT averaged 196 ± 38.1 minutes, with no clear downward trend observed. The mean time of surgery for RFT was 156.9 ± 16.3 minutes, with a steady trend toward shorter surgical times. All 5 RAT patients were managed with drains and as inpatients (length of stay = 1.0 days); 9 of 10 RFT patients were managed without drains and on an outpatient basis (the first patient had a drain and was observed for 1 night in the hospital; P < .001). Ease of surgery, familiarity with anatomic dissection planes, and surgeon comfort level all favored RFT. CONCLUSIONS: In an early experience of a small series of patients, a more rapid learning curve reflected by shorter operative times was observed with robotic facelift thyroidectomy compared with robotic axillary thyroidectomy. Furthermore, the vast majority of patients could be managed as outpatients, which represents one of several apparent advantages.
OBJECTIVES: Two distinct remote access robotic thyroidectomy techniques were implemented in a high-volume endocrine surgery practice. Important technical and clinical differences were observed and are described. STUDY DESIGN: Cross-sectional study with planned data collection. SETTING: Thyroid center. SUBJECTS AND METHODS: A panel of demographic and clinical parameters was captured in a series of patients undergoing 1 of 2 robotic thyroidectomy techniques (robotic axillary thyroidectomy [RAT] or robotic facelift thyroidectomy [RFT]). Particular attention was paid to time of surgery, ease of dissection, complications, use of drains, and length of stay. RESULTS: Fifteen robotic hemithyroidectomies were accomplished by either RAT (n = 5) or RFT (n = 10). The duration of surgery for RAT averaged 196 ± 38.1 minutes, with no clear downward trend observed. The mean time of surgery for RFT was 156.9 ± 16.3 minutes, with a steady trend toward shorter surgical times. All 5 RATpatients were managed with drains and as inpatients (length of stay = 1.0 days); 9 of 10 RFT patients were managed without drains and on an outpatient basis (the first patient had a drain and was observed for 1 night in the hospital; P < .001). Ease of surgery, familiarity with anatomic dissection planes, and surgeon comfort level all favored RFT. CONCLUSIONS: In an early experience of a small series of patients, a more rapid learning curve reflected by shorter operative times was observed with robotic facelift thyroidectomy compared with robotic axillary thyroidectomy. Furthermore, the vast majority of patients could be managed as outpatients, which represents one of several apparent advantages.
Authors: Hyung Kwon Byeon; F Christopher Holsinger; Ralph P Tufano; Jae Hong Park; Nam Suk Sim; Won Shik Kim; Eun Chang Choi; Yoon Woo Koh Journal: Surg Endosc Date: 2015-04-15 Impact factor: 4.584
Authors: William S Duke; F Christopher Holsinger; Emad Kandil; Jeremy D Richmon; Michael C Singer; David J Terris Journal: World J Surg Date: 2017-01 Impact factor: 3.352