title: Technical and oncologic safety of robotic thyroid surgery.
abstract: BACKGROUND
  The aim of this study was to evaluate the surgical outcomes of a double-incision robot-assisted gasless transaxillary thyroidectomy procedure compared with conventional open thyroid surgery.
  
  
  METHODS
  We enrolled and analyzed 521 female patients with classic papillary thyroid carcinoma (PTC) who underwent a total thyroidectomy with central compartment node dissection (CCND) at the Asan Medical Center in Seoul, Korea from December 2008 to December 2010. These patients were classified into robotic (N = 98) or open (N = 423) groups and were compared with respect to clinicopathologic characteristics, complications, and stimulated thyroglobulin (sTg) levels at the time of immediate postoperative radioactive iodine remnant ablation (ablation sTg) and at 6-12 months after the first ablation (control sTg).
  
  
  RESULTS
  The rate of perioperative complications was also similar, except for transient hypoparathyroidism in the robotic group. The median ablation sTg levels (0.39 vs 0.50 ng/mL, P = 0.215) and the proportion of patients with ablation sTg levels <10 ng/mL (94.5 vs 98.0 %, P = 0.103) were also comparable between the robotic and open groups. In addition, the proportion of patients with control sTg levels <1 ng/mL in both robotic and open groups (91.3 vs 95.6 %, P = 0.079) did not show a significant difference.
  
  
  CONCLUSIONS
  Robotic thyroid surgery using a double-incision gasless transaxillary approach is technically safe and may provide a feasible option for a complete thyroid resection and adequate lymph node dissection in patients with PTC.
authors.affiliation: Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Onvox
authors.initials: O
authors.lastname: Yi
authors.forename: Jong Ho
authors.initials: JH
authors.lastname: Yoon
authors.forename: Yu-Mi
authors.initials: YM
authors.lastname: Lee
authors.forename: Tae-Yon
authors.initials: TY
authors.lastname: Sung
authors.forename: Ki-Wook
authors.initials: KW
authors.lastname: Chung
authors.forename: Tae Yong
authors.initials: TY
authors.lastname: Kim
authors.forename: Won Bae
authors.initials: WB
authors.lastname: Kim
authors.forename: Young Kee
authors.initials: YK
authors.lastname: Shong
authors.forename: Jin-Sook
authors.initials: JS
authors.lastname: Ryu
authors.forename: Suck Joon
authors.initials: SJ
authors.lastname: Hong
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000097:blood / Q000000981:diagnostic imaging / Q000628:therapy*; D002291:Carcinoma, Papillary; D005260:Female; D006801:Humans; D007011:Hypoparathyroidism / Q000209:etiology; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008875:Middle Aged; D012189:Retrospective Studies; D012371:Robotics; D013954:Thyroglobulin / Q000097:blood; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000628:therapy*; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods*; D014463:Ultrasonography
chemical_list: D007457:Iodine Radioisotopes; D013954:Thyroglobulin