title: Robotic transaxillary thyroid lobectomy of a follicular neoplasm.
abstract: OBJECTIVE
  Minimally invasive thyroid surgery using various techniques is well described. The purpose of this video is to show a robotic-assisted transaxillary right thyroid lobectomy for a follicular neoplasm with intraoperative nerve monitoring and stimulation of recurrent laryngeal nerve. Herein, we show our experience with the technique and its safety and feasibility.
  
  
  METHODS
  We performed a right thyroid lobectomy on a 33-year-old patient using the da Vinci-Si-HD Surgical System. The operation was done via a single axillary incision, 5 cm in length. The flap creation time was approximately 26 min. The robot docking time was 6 min. The recurrent laryngeal nerve was identified and nerve stimulation was used to stimulate with 0.5 milliamps. The operative console time was 21 min. Total operative time was 69 min.
  
  
  RESULTS
  The procedure was successfully completed. Blood loss was minimal. Postoperative laryngoscopy showed intact and mobile bilateral vocal cords. There were no complications. Patient was discharged 4 h after surgery.
  
  
  CONCLUSIONS
  Robotic transaxillary endoscopic gasless thyroid surgery with monitoring and stimulation of the RLN is feasible and safe. This technique eliminates a visible neck scar and affords excellent high definition optics of the cervical anatomy. This new technique can be accomplished on an outpatient basis.
authors.affiliation: Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA.
authors.forename: Saleh
authors.initials: S
authors.lastname: Massasati
authors.forename: Salem
authors.initials: S
authors.lastname: Noureldine
authors.forename: Rizwan
authors.initials: R
authors.lastname: Aslam
authors.forename: Emad
authors.initials: E
authors.lastname: Kandil
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000601:surgery*; D000328:Adult; D005240:Feasibility Studies; D006801:Humans; D016343:Monitoring, Intraoperative; D011183:Postoperative Complications; D011379:Prognosis; D012009:Recurrent Laryngeal Nerve / Q000601:surgery*; D012371:Robotics; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy; D013997:Time Factors