Neil Tolley1, George Garas1, Fausto Palazzo2, Alexa Prichard1, Konstantinos Chaidas1, Jeremy Cox3, Ara Darzi4, Asit Arora1. 1. Department of Otorhinolaryngology and Head & Neck Surgery, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom. 2. Department of Endocrine and Thyroid Surgery, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom. 3. Department of Endocrinology, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom. 4. Department of Surgery and Cancer, Imperial College London, St. Mary's Hospital Campus, London, United Kingdom.
Abstract
BACKGROUND: Targeted parathyroidectomy is a popular technique for localized pathology. No single technique is established as superior. The purpose of this study was to compare robotic-assisted parathyroidectomy (RAP) with the most common approach. METHODS: This was a prospective, nonrandomized study. Fifteen consecutive patients who underwent RAP were compared to 15 matched controls undergoing focused lateral parathyroidectomy (FLP). RESULTS: Biochemical cure occurred in 29 of 30 patients (97%). No major complications occurred, although there was 1 robotic conversion. RAP demonstrated a significant time reduction (R(2) = 0.436; p = .01) but took much longer to perform than FLP (119 minutes vs 34 minutes; p = .001). RAP was associated with less initial postoperative pain (p = .036) and higher satisfaction with scar cosmesis (p = .002) until 6 months. Quality of life (QOL) improved in both groups (p = .007). CONCLUSION: RAP provides superior early cosmesis with equivalent global health improvement compared to FLP. The high cost and learning curve may preclude widespread adoption. Further evaluation is necessary to establish its clinical efficacy regarding scar cosmesis.
BACKGROUND: Targeted parathyroidectomy is a popular technique for localized pathology. No single technique is established as superior. The purpose of this study was to compare robotic-assisted parathyroidectomy (RAP) with the most common approach. METHODS: This was a prospective, nonrandomized study. Fifteen consecutive patients who underwent RAP were compared to 15 matched controls undergoing focused lateral parathyroidectomy (FLP). RESULTS: Biochemical cure occurred in 29 of 30 patients (97%). No major complications occurred, although there was 1 robotic conversion. RAP demonstrated a significant time reduction (R(2) = 0.436; p = .01) but took much longer to perform than FLP (119 minutes vs 34 minutes; p = .001). RAP was associated with less initial postoperative pain (p = .036) and higher satisfaction with scar cosmesis (p = .002) until 6 months. Quality of life (QOL) improved in both groups (p = .007). CONCLUSION: RAP provides superior early cosmesis with equivalent global health improvement compared to FLP. The high cost and learning curve may preclude widespread adoption. Further evaluation is necessary to establish its clinical efficacy regarding scar cosmesis.
Authors: George Garas; Nick J Roland; Jeffrey Lancaster; Matthew Zammit; Victoria A Manon; Katharine Davies; Terry M Jones; Mriganka De; Floyd C Holsinger; Robin J D Prestwich; Jason C Fleming Journal: Ann Surg Oncol Date: 2022-07-16 Impact factor: 4.339
Authors: George Garas; Sheraz R Markar; George Malietzis; Hutan Ashrafian; George B Hanna; Emmanouil Zacharakis; Long R Jiao; Athanassios Argiris; Ara Darzi; Thanos Athanasiou Journal: Ann Surg Oncol Date: 2017-11-06 Impact factor: 5.344