title: Robotic thyroid surgery: our experience with the infraclavicular approach.
abstract: BACKGROUND
  Robot-assisted endoscopic transaxillary thyroidectomy is an emerging surgical technique. Despite promising results it presents some limitations and remains controversial in terms of usefulness and validity. We developed an alternative robotic technique using a gasless infraclavicular approach.
  
  
  METHODS
  We tested this approach using cadaveric dissection, then we performed the technique on a series of 21 patients from October 2009 to July 2010.
  
  
  RESULTS
  Sixteen patients underwent total thyroidectomy and 5 patients underwent lobectomies. Mean total operative time was 197 minutes. We observed postoperative complications in 4 patients. Pathologic diagnoses included: benign follicular adenoma (19 patients) and single papillary carcinoma <1 cm in diameter pT1a (2 patients).
  
  
  CONCLUSIONS
  The infraclavicular approach for robotic thyroidectomy is feasible, but is not safe enough to be recommended, based on our experience and on the technical difficulties encountered. The use of 2 robotic arms instead of 3 is a major limitation for this technique.
authors.affiliation: Service d'ORL et Chirurgie maxillo-faciale, Centre Hospitalier Universitaire de Nîmes, Nîmes, France. Benjamin.lallemant@chu-nimes.fr
authors.forename: Benjamin
authors.initials: B
authors.lastname: Lallemant
authors.forename: Guillaume
authors.initials: G
authors.lastname: Chambon
authors.forename: Damien
authors.initials: D
authors.lastname: Rupp
authors.forename: Christophe
authors.initials: C
authors.lastname: Reynaud
authors.forename: Caroline
authors.initials: C
authors.lastname: Alovisetti
authors.forename: Sophie
authors.initials: S
authors.lastname: Kacha
authors.forename: Jean-Gabriel
authors.initials: JG
authors.lastname: Lallemant
authors.forename: Vincent
authors.initials: V
authors.lastname: Trevillot
mesh_terms: D000328:Adult; D000368:Aged; D002102:Cadaver; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications; D012371:Robotics / Q000379:methods*; D013961:Thyroid Gland / Q000473:pathology / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*