The impact of body habitus on the surgical outcomes of transaxillary single-incision robotic thyroidectomy in papillary thyroid carcinoma patients.
BACKGROUND
Robotic applications have achieved safe and precise thyroidectomy with notable cosmetic and functional benefits. This study was designed to document the influence of body habitus on robotic thyroidectomy in papillary thyroid carcinoma (PTC) patients.


METHODS
From July 2009 to February 2010, 352 patients underwent robotic thyroidectomy using a gasless, transaxillary single-incision approach at Yonsei University Health System. Body habitus was described using body mass index category (normal weight, overweight, obese), neck length, shoulder width, and shoulder width to neck length ratios. The impact of body habitus on surgical outcomes was analyzed with respect to operation time, number of retrieved central nodes, bleeding amount, and postoperative complications.


RESULTS
Of the 352 patients, 217 underwent less than total thyroidectomy and 135 underwent total thyroidectomy. Operative variables (i.e. operation times, bleeding amounts, and numbers of retrieved central nodes) showed no significant differences between three BMI groups for less than total thyroidectomy. However, total operation and working space times were longer for obese patients during total thyroidectomy. In particular, shoulder width was positively correlated with total operation time, working space time, console time, and number of retrieved central nodes. On the other hand, postoperative complications were not significantly different in the three BMI groups and showed no significant correlation with the other indices of body habitus.


CONCLUSIONS
Standardized robotic thyroidectomy can be performed safely and feasibly in patients with a large body habitus despite longer operation times.
Department of Surgery, Yonsei University Health System, C.P.O. Box 8044, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, South Korea.
Sohee
S
Lee
Seulkee
S
Park
Cho Rok
CR
Lee
Haiyoung
H
Son
Jungwoo
J
Kim
Sang-Wook
SW
Kang
Jong Ju
JJ
Jeong
Kee-Hyun
KH
Nam
Woong Youn
WY
Chung
Cheong Soo
CS
Park
D000293:Adolescent; D000328:Adult; D000368:Aged; D000886:Anthropometry; D016063:Blood Loss, Surgical; D015992:Body Mass Index; D002291:Carcinoma, Papillary / Q000601:surgery; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000033:anatomy & histology; D061646:Operative Time; D063868:Patient Outcome Assessment; D011183:Postoperative Complications; D012371:Robotics; D012782:Shoulder / Q000033:anatomy & histology; D013964:Thyroid Neoplasms / Q000601:surgery; D013965:Thyroidectomy; D055815:Young Adult