Feasibility and surgical approach of transaxillary robotic thyroidectomy without CO2 insufflation

✍ Scribed by Carol M. Lewis; Woong Y. Chung; F. Christopher Holsinger

• Book ID: 102234011
• Publisher: John Wiley and Sons
• Year: 2009
• Tongue: English
• Weight: 174 KB
• Volume: 32
• Category: Article
• ISSN: 1043-3074
• DOI: 10.1002/hed.21318

✦ Synopsis

Abstract

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. © 2009 Wiley Periodicals, Inc. Head Neck, 2010