Ji Young You1, HoonYub Kim2, Da Won Park1, Hsien Wen Yang1, Gianlorenzo Dionigi3, Ralph P Tufano4. 1. Department of Surgery, Korea University Medical Center Thyroid Center, Korea University Hospital, Korea University College of Medicine, Seoul, Korea. 2. Department of Surgery, Korea University Medical Center Thyroid Center, Korea University Hospital, Korea University College of Medicine, Seoul, Korea. Electronic address: hoonyubkim@korea.ac.kr. 3. Division for Endocrine and Minimal Invasive Surgery, Department of Human Pathology in Adulthood and Childhood "G.Barresi," University Hospital "G.Martino," University of Messina, Italy. 4. Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD.
Abstract
BACKGROUND: Although there are several publications on the new transoral robotic thyroidectomy technique, few have thoroughly reviewed its associated complications. This study analyzed the causes and prevention of transoral robotic thyroidectomy-specific complications and presented preventive measures. METHODS: The medical records of patients who underwent transoral robotic thyroidectomy performed by a single surgeon between March 1, 2009 and April 30, 2019 were retrospectively analyzed. Patient demographic, clinical, and operative data were analyzed using descriptive statistics. We describe the transoral robotic thyroidectomy-related complications experienced at our institution and how to overcome them. RESULTS: This study included a total of 423 patients who underwent transoral robotic thyroidectomy. The general surgical complications included immediate postoperative bleeding (2 cases) and delayed hematoma (3 cases). Chyle leakage and localized wound infection were found in 1 case each. Transient vocal cord palsy occurred in 4 cases, and 1 case developed transient hypoparathyroidism. The transoral robotic thyroidectomy-specific complications included zygoma bruise (2 cases), flap bruise (3 cases), chin flap perforation (2 cases), and oral commissure tearing (2 cases). The complications occurring when creating the flap included flap burns (4 cases), skin dimpling in the midline of the lower chin (2 cases), and hematomas in the intraoral trocar insertion sites (3 cases). CONCLUSION: Surgeons familiar with thyroid surgery and experienced in robotic surgery can perform transoral robotic thyroidectomy without causing more complications than those seen with traditional surgery.
BACKGROUND: Although there are several publications on the new transoral robotic thyroidectomy technique, few have thoroughly reviewed its associated complications. This study analyzed the causes and prevention of transoral robotic thyroidectomy-specific complications and presented preventive measures. METHODS: The medical records of patients who underwent transoral robotic thyroidectomy performed by a single surgeon between March 1, 2009 and April 30, 2019 were retrospectively analyzed. Patient demographic, clinical, and operative data were analyzed using descriptive statistics. We describe the transoral robotic thyroidectomy-related complications experienced at our institution and how to overcome them. RESULTS: This study included a total of 423 patients who underwent transoral robotic thyroidectomy. The general surgical complications included immediate postoperative bleeding (2 cases) and delayed hematoma (3 cases). Chyle leakage and localized wound infection were found in 1 case each. Transient vocal cord palsy occurred in 4 cases, and 1 case developed transient hypoparathyroidism. The transoral robotic thyroidectomy-specific complications included zygoma bruise (2 cases), flap bruise (3 cases), chin flap perforation (2 cases), and oral commissure tearing (2 cases). The complications occurring when creating the flap included flap burns (4 cases), skin dimpling in the midline of the lower chin (2 cases), and hematomas in the intraoral trocar insertion sites (3 cases). CONCLUSION: Surgeons familiar with thyroid surgery and experienced in robotic surgery can perform transoral robotic thyroidectomy without causing more complications than those seen with traditional surgery.