title: Robotic thyroid surgery: an initial experience with North American patients.
abstract: OBJECTIVE
  To review the initial experience of gasless transaxillary robot-assisted endoscopic thyroid surgery in a series of patients and describe modifications of the technique for the North American patients, selection criteria, and other issues related to this technology.
  
  
  METHODS
  Retrospective review of the first 31 consecutive cases at a single institution.
  
  
  RESULTS
  Thirty-one patients underwent robotic thyroid surgery. Twenty thyroid lobectomies and 11 total thyroidectomies were performed. Improvements in the length of time to perform components of the procedure were noted from the early group of cases to later group of cases. No major or permanent complications occurred.
  
  
  CONCLUSIONS
  Robotic thyroid surgery is feasible in North American patients and can be safely performed. The procedure has potential complications and a definite learning curve exists for both surgeons and operating room staff. Training methods need to be validated to ensure safe adoption. More studies need to be performed to further evaluate the relative benefits of this technique.
authors.affiliation: Texas Institute for Thyroid and Parathyroid Surgery, College Station, Texas 77845, USA. rbk@texasentandallergy.com
authors.forename: Ronald B
authors.initials: RB
authors.lastname: Kuppersmith
authors.forename: F Christopher
authors.initials: FC
authors.lastname: Holsinger
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000601:surgery; D000231:Adenocarcinoma, Papillary / Q000601:surgery; D000328:Adult; D001365:Axilla / Q000601:surgery; D004724:Endoscopy / Q000193:education / Q000295:instrumentation*; D005260:Female; D006111:Graves Disease / Q000601:surgery; D050031:Hashimoto Disease / Q000601:surgery; D006801:Humans; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation*; D010149:Postoperative Pain / Q000209:etiology; D056888:Patient Positioning; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012371:Robotics / Q000193:education / Q000295:instrumentation*; D025321:Surgery, Computer-Assisted / Q000193:education / Q000295:instrumentation*; D013959:Thyroid Diseases / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000601:surgery*; D016606:Thyroid Nodule / Q000601:surgery; D013965:Thyroidectomy / Q000193:education / Q000295:instrumentation*; D020535:Video-Assisted Surgery / Q000295:instrumentation*; D055815:Young Adult