title: Robotic transaxillary thyroidectomy with gasless approach in a girl with goitre.
abstract: BACKGROUND
  Robotic-assisted transaxillary thyroidectomy is a minimally invasive approach for the removal of the thyroid through the axilla. This technique eliminates a visible scar and affords excellent optics of the cervical anatomy. We sought to describe the technique and outcome for transaxillary gasless subtotal thyroidectomy in the paediatric population.
  
  
  METHODS
  A 13 year-old female with an enlarged goitre underwent a transaxillary robot-assisted gasless subtotal thyroidectomy in an academic institution. The main outcome measures were feasibility of the robotic approach, patient and gland characteristics, operative time and complications.
  
  
  RESULTS
  There was no conversion to laparoscopic or open surgery. The robotic docking time was 110 min and total operative time was 150 min. The patient tolerated the procedure well. Estimated blood loss was 10 ml. The patient was discharged within 24 h. There were no perioperative or postoperative complications. In addition there was no evidence of postoperative vocal cord palsy or paresis.
  
  
  CONCLUSIONS
  This initial experience demonstrates that this technique can be a feasible, safe and effective method for subtotal thyroidectomy in the paediatric population. The use of robotic technology for endoscopic thyroid surgery could overcome the limitations of conventional endoscopic surgeries in the surgical management of thyroid disease.
authors.affiliation: Department of Surgery, Endocrine and Oncological Surgery Division, Tulane University School of Medicine, New Orleans, LA 70112, USA. ekandil@tulane.edu
authors.forename: Emad
authors.initials: E
authors.lastname: Kandil
authors.forename: Salem
authors.initials: S
authors.lastname: Noureldine
authors.forename: Mohamed Abdel
authors.initials: MA
authors.lastname: Khalek
authors.forename: Rizwan
authors.initials: R
authors.lastname: Aslam
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Ekaidi
authors.forename: Rodney
authors.initials: R
authors.lastname: Steiner
authors.forename: Floyd C
authors.initials: FC
authors.lastname: Holsinger
mesh_terms: D000293:Adolescent; D004724:Endoscopy / Q000379:methods; D005260:Female; D005740:Gases; D006042:Goiter / Q000601:surgery*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D012371:Robotics / Q000379:methods*; D025321:Surgery, Computer-Assisted; D013514:Surgical Procedures, Operative / Q000379:methods; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D005740:Gases