BACKGROUND: Although endoscopic thyroid surgery is gaining wide acceptance, existing endoscopic methods for thyroidectomy are blamed for the increased frequency of flap dissections and longer surgical times. More recently, transoral endoscopic thyroidectomy has overcome the limitations of previous approaches. Herein, we present our initial experience with transoral periosteal thyroidectomy (TOPOT) in cadaver and porcine models. Using these models, the surgical view was improved and had greater freedom of motion; the technique was then performed in human subjects using robotic TOPOT, which has not previously been reported. METHOD: TOPOTs were performed in seven fresh human cadavers and ten live pigs. Total thyroidectomies were performed in all cadavers and pigs. After the cadaver and animal trials, four human patients underwent robotic TOPOT performed using the da Vinci® surgical system at Korea University Anam Hospital. Recurrent laryngeal nerve function, intra- and postoperative complications, and postoperative outcomes were assessed in all patients. RESULT: One left lobectomy for follicular adenoma, two right lobectomies for nodular hyperplasia, and one left lobectomy with a central neck dissection for papillary thyroid microcarcinoma were performed in the human subjects using a robotic transoral periosteal approach. In three cases, paresthesia occurred in the mental nerve, but this improved within 4 weeks in all cases. No local infections occurred at the incision site or anterior neck, and no recurrent laryngeal nerve cord palsies occurred postoperatively. CONCLUSION: TOPOT may be an effective and safe approach for robotic thyroid surgery.
BACKGROUND: Although endoscopic thyroid surgery is gaining wide acceptance, existing endoscopic methods for thyroidectomy are blamed for the increased frequency of flap dissections and longer surgical times. More recently, transoral endoscopic thyroidectomy has overcome the limitations of previous approaches. Herein, we present our initial experience with transoral periosteal thyroidectomy (TOPOT) in cadaver and porcine models. Using these models, the surgical view was improved and had greater freedom of motion; the technique was then performed in human subjects using robotic TOPOT, which has not previously been reported. METHOD: TOPOTs were performed in seven fresh human cadavers and ten live pigs. Total thyroidectomies were performed in all cadavers and pigs. After the cadaver and animal trials, four humanpatients underwent robotic TOPOT performed using the da Vinci® surgical system at Korea University Anam Hospital. Recurrent laryngeal nerve function, intra- and postoperative complications, and postoperative outcomes were assessed in all patients. RESULT: One left lobectomy for follicular adenoma, two right lobectomies for nodular hyperplasia, and one left lobectomy with a central neck dissection for papillary thyroid microcarcinoma were performed in the human subjects using a robotic transoral periosteal approach. In three cases, paresthesia occurred in the mental nerve, but this improved within 4 weeks in all cases. No local infections occurred at the incision site or anterior neck, and no recurrent laryngeal nerve cord palsies occurred postoperatively. CONCLUSION: TOPOT may be an effective and safe approach for robotic thyroid surgery.
Authors: Sang-Wook Kang; Seung Chul Lee; So Hee Lee; Kang Young Lee; Jong Ju Jeong; Yong Sang Lee; Kee-Hyun Nam; Hang Seok Chang; Woong Youn Chung; Cheong Soo Park Journal: Surgery Date: 2009-10-30 Impact factor: 3.982
Authors: Hong Kyu Kim; Young Jun Chai; Gianlorenzo Dionigi; Eren Berber; Ralph P Tufano; Hoon Yub Kim Journal: World J Surg Date: 2019-04 Impact factor: 3.352