Endocrine Abstracts

Background: Many endoscopic minimaly invasive procedures have been developed and are used now in thyroid and parathyroid surgery. However, the endoscopic approach is more technically demanding and due its limitations, endoscopic thyroidectomy remains limited in application and practiced in a relatively small number of centers. Recently robotic technology has been also applied to thyroid surgery. The aim of this study is to present our experience and to demonstrate the technical feasibility, intraoperative safety and efficacy of robotic thyroidectomy.

Methods: The technique that we are practicing use the unilateral transaxillary approach without gas insufflation. We used the da Vinci SI Surgical Robotic System for all interventions and we performed 35 total unilateral lobectomy and 7 total thyroidectomy. Patients were diagnosed with unilateral thyroid nodules and 7 of them, whit bilateral thyroid nodules. For each patient we analyzed the clinical characteristics, tumor size, pathologic type, operative time, amount of drainage, duration of hospital stay, postoperative complications, postoperative neck and anterior chest pain, and cosmetic satisfaction.

Results: All operations were performed successfully without any need for conventional open conversion. The mean overall operation time was 155 min respectively 80 min console time. The mean tumor size was 3.5 cm. There was one temporal brachial plexus neuropraxia and 4 wound seroma. There were 2 malignant thyroid lesions at the final histopathological results. In this situation we perform total thyroidectomy by open cervicotomy during the same hospitalisation.

Conclusions: Robotic technology overcame some technical limitations associated with conventional endoscopy. Robotic thyroidectomy by gasless transaxillary method is feasible, safe, and provided good outcomes.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.