Current status of robotic thyroid surgery in South Korea: a web-based survey.
BACKGROUND
More than 8,000 cases of robotic thyroidectomy (RoT) were performed in South Korea from 2007 to 2011 using either a transaxillary approach (TAA) or a bilateral axillo-breast approach (BABA). However, there is no consensus regarding patient selection for RoT. This study used a web-based survey questionnaire to examine the current status of RoT in South Korea.


METHODS
Thirty-two of 50 surgeons (64.0 %) who had performed RoT in South Korea participated in the web-based survey in August 2011. The questionnaires comprised four main domains: surgeon characteristics, surgical approach, patient selection, and future prospects.


RESULTS
In terms of surgical approach, 43.8 % respondents used the TAA method and 53.1 % used the BABA method. The main advantage cited by surgeons using the TAA method was that it made lateral lymph node dissection easier (35.7 %), whereas those using the BABA method cited more cosmesis (100 %) and ease of performing a contralateral thyroidectomy (88.2 %). Papillary thyroid cancer ≤2 cm (65.3 %), intracapsular lesion (76.7 %), nonposterior location (53.6 %), and no clinical evidence of lateral lymph node metastasis (76.7 %) were cited as main indications for RoT. Of respondents, 87.5 % agreed that RoT would play a future role as a treatment modality for thyroid disease.


CONCLUSIONS
Opinions differed regarding the advantages and disadvantages of two approaches for RoT. This may be due to differences in surgical procedure itself between two approach methods. Accumulation of RoT surgeon's experiences might establish consensus regarding patient selection and indications for the RoT will need to be further investigated.
Department of Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea, md.ds.bae@gmail.com.
Dong Sik
DS
Bae
Do Hoon
do H
Koo
June Young
JY
Choi
Eunyoung
E
Kim
Kyu Eun
KE
Lee
Yeo-Kyu
YK
Youn
D001365:Axilla; D001940:Breast; D002277:Carcinoma / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D002291:Carcinoma, Papillary; D019538:Health Care Surveys; D006801:Humans; D020407:Internet; D059032:Learning Curve; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D018579:Patient Selection; D010818:Practice Patterns, Physicians'; D056910:Republic of Korea; D065287:Robotic Surgical Procedures / Q000193:education / Q000379:methods*; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000193:education / Q000379:methods*