title: Initial experience using robot- assisted transaxillary thyroidectomy for Graves' disease.
abstract: BACKGROUND
  Graves' disease is the most common form of hyperthyroidism and surgery to remove the thyroid gland is a common treatment option for many of these patients. Interestingly, due to the enlarged gland size, their high vascularity, and the difficulty to control bleeding, many authors feel that Graves' disease remains a contraindication to current endoscopic techniques. We hypothesize that performing robotic subtotal thyroidectomy in Graves' disease settings could overcome the limitations of conventional endoscopic surgeries in the surgical management of this challenging thyroid disease.
  
  
  METHODS
  Prospective study in an academic hospital.
  
  
  RESULTS
  Sixty-seven patients had robotic transaxillary thyroidectomy within a year. Of these, five cases (7%) were done for Graves' disease. There were three females and two males (mean age, 36 years). There were no conversions to laparoscopic or open surgery. The mean (SD) thyroid volume was 16.6 (3.2) ml. The mean (SD) operative time was 159 (17.8)min and docking time was 81 (20)min. Mean blood loss was 18 mL. All patients were discharged home in 24h. There were no perioperative or postoperative complications. There was no evidence of postoperative vocal cord palsy or paresis.
  
  
  CONCLUSIONS
  We showed that robotic transaxillary thyroidectomy is feasible and can be safe and effective in patients with Graves' disease. To our knowledge, this is the first article describing this approach for Graves' disease. These findings, however, warrant additional investigation within future prospective clinical trials.
authors: Department of Surgery, Endocrine and Oncological Surgery Division, New Orleans, LA, USA. ekandil@tulane.edu
authors: E
authors: E
authors: Kandil
authors: S
authors: S
authors: Noureldine
authors: M
authors: M
authors: Abdel Khalek
authors: S
authors: S
authors: Alrasheedi
authors: R
authors: R
authors: Aslam
authors: P
authors: P
authors: Friedlander
authors: F C
authors: FC
authors: Holsinger
authors: C F
authors: CF
authors: Bellows
mesh_terms: D000328:Adult; D001365:Axilla / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006111:Graves Disease / Q000601:surgery*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012371:Robotics; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome