title: Robotic thyroid surgery for papillary thyroid carcinoma: lessons learned from 100 consecutive surgeries.
abstract: OBJECTIVE
  To evaluate the feasibility and safety of robotic thyroidectomy using the da Vinci surgical system.
  
  
  METHODS
  Between July 2008 and April 2011, the data revealed an initial series of 100 consecutive patients who underwent robotic thyroidectomy with the da Vinci-S surgical system using the bilateral axillo-breast approach for thyroid cancer. Prospectively collected data were analyzed retrospectively.
  
  
  RESULTS
  There were 88 cases of total thyroidectomy, 11 cases of lobectomy, and 1 case of total thyroidectomy with modified radical neck dissection. There was no conversion. The mean total operation time was 287.15±45.19 minutes for total thyroidectomy and 236.27±48.98 minutes for lobectomy. Nineteen patients experienced transient hypocalcemia and 3 patients experienced transient vocal fold palsy. All of the patients recovered within 3 months.
  
  
  CONCLUSIONS
  Robotic thyroid surgery for patients with thyroid malignancy is safe and results in fewer postoperative complications than open thyroid surgery.
authors: Department of Surgery, Korea University College of Medicine, Seoul, Korea.
authors: Hye Yoon
authors: HY
authors: Lee
authors: In Soo
authors: IS
authors: Yang
authors: Seong Bae
authors: SB
authors: Hwang
authors: Jae Bok
authors: JB
authors: Lee
authors: Jeoung Won
authors: JW
authors: Bae
authors: Hoon Yub
authors: HY
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D001365:Axilla; D001940:Breast; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D002291:Carcinoma, Papillary; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000009:adverse effects* / Q000295:instrumentation; D061646:Operative Time; D011446:Prospective Studies; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects* / Q000295:instrumentation; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects* / Q000295:instrumentation; D016896:Treatment Outcome; D055815:Young Adult
references: Gagner M. Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism. Br J Surg. 1996;83:875.
references: Ikeda Y, Takami H, Sasaki Y, et al.. Endoscopic neck surgery by the axillary approach. J Am Coll Surg. 2000;191:336–340.
references: Kang SW, Jeong JJ, Yun JS, et al.. Gasless endoscopic thyroidectomy using trans-axillary approach; surgical outcome of 581 patients. Endocr J. 2009;56:361–369.
references: Yoon JH, Park CH, Chung WY. Gasless endoscopic thyroidectomy via an axillary approach: experience of 30 cases. Surg Laparosc Endosc Percutan Tech. 2006;16:226–231.
references: Lee KE, Rao J, Youn YK. Endoscopic thyroidectomy with the da Vinci robot system using the bilateral axillary breast approach (BABA) technique: our initial experience. Surg Laparosc Endosc Percutan Tech. 2009;19:e71–e75.
references: Kang SW, Jeong JJ, Yun JS, et al.. Robot-assisted endoscopic surgery for thyroid cancer: experience with the first 100 patients. Surg Endosc. 2009;23:2399–2406.
references: Nifong LW, Chitwood WR, Pappas PS, et al.. Robotic mitral valve surgery: a United States multicenter trial. J Thorac Cardiovasc Surg. 2005;129:1395–1404.
references: Mikhail AA, Orvieto MA, Billatos ES, et al.. Robotic-assisted laparoscopic prostatectomy: first 100 patients with one year of follow-up. Urology. 2006;68:1275–1279.
references: Hüscher CS, Chiodini S, Napolitano C, et al.. Endoscopic right thyroid lobectomy. Surg Endosc. 1997;11:877.
references: Lee KE, Koo do H, Kim SJ, et al.. Outcomes of 109 patients with papillary thyroid carcinoma who underwent robotic total thyroidectomy with central node dissection via the bilateral axillo-breast approach. Surgery. 2010;148:1207–1213.
references: Kang SW, Lee SC, Lee SH, et al.. Robotic thyroid surgery using a gasless, transaxillary approach and the da Vinci S system: the operative outcomes of 338 consecutive patients. Surgery. 2009;146:1048–1055.
references: Lee J, Nah KY, Kim RM, et al.. Differences in postoperative outcomes, function, and cosmesis: open versus robotic thyroidectomy. Surg Endosc. 2010;24:3186–3194.
references: Lee KE, Koo do H, Im HJ, et al.. Surgical completeness of bilateral axillo-breast approach robotic thyroidectomy: comparison with conventional open thyroidectomy after propensity score matching. Surgery. 2011;150:1266–1274.
references: Lee S, Ryu HR, Park JH, et al.. Early surgical outcomes comparison between robotic and conventional open thyroid surgery for papillary thyroid microcarcinoma. Surgery. 2012;151:724–730.
references: Im HJ, Koo do H, Paeng JC, et al.. Evaluation of surgical completeness in endoscopic thyroidectomy compared with open thyroidectomy with regard to remnant ablation. Clin Nucl Med. 2012;37:148–151.
references: Yoo H, Chae BJ, Park HS, et al.. Comparison of surgical outcomes between endoscopic and robotic thyroidectomy. J Surg Oncol. 2012;105:705–708.
references: Kim WW, Kim JS, Hur SM, et al.. Is robotic surgery superior to endoscopic and open surgeries in thyroid cancer? World J Surg. 2011;35:779–784.
references: Jacob BP, Gagner M. Robotics and general surgery. Surg Clin North Am. 2003;83:1405–1419.
references: Kang SW, Jeong JJ, Nam KH, et al.. Robot-assisted endoscopic thyroidectomy for thyroid malignancies using a gasless transaxillary approach. J Am Coll Surg. 2009;209:e1–e7.
references: Lee S, Ryu HR, Park JH, et al.. Excellence in robotic thyroid surgery: a comparative study of robot-assisted versus conventional endoscopic thyroidectomy in papillary thyroid microcarcinoma patients. Ann Surg. 2011;253:1060–1066.
references: Foley CS, Agcaoglu O, Siperstein AE, et al.. Robotic transaxillary endocrine surgery: a comparison with conventional open technique. Surg Endosc. 2012;26:2259–2266.
references: Flegal KM, Carroll MD, Ogden CL, et al.. Prevalence and trends in obesity among US adults, 1999-2008. JAMA. 2010;303:235–241.
references: Link RE, Bhayani SB, Kavoussi LR. A prospective comparison of robotic and laparoscopic pyeloplasty. Ann Surg. 2006;243:486–491.