title: Trends in Robotic Thyroid Surgery in the United States from 2009 Through 2013.
abstract: BACKGROUND
  The objective of this study was to describe national trends in robotic thyroid surgery from 2009 through 2013.
  
  
  METHODS
  The University HealthSystem Consortium (UHC) database was searched for patients undergoing robotic thyroidectomy (RT) from 2009 through 2013. Another U.S. institution's RT data, not included in the UHC database, were also evaluated. Patient demographics, institutional volume, comorbid conditions, complications, and cost information were analyzed.
  
  
  RESULTS
  Sixty-one institutions performed 484 RT during the study period. From 2009 through 2011, U.S. annual RT volume increased from 39 cases to 140. Annual volume dropped to 69 cases in 2012 and 93 cases in 2013. Higher-volume centers reported lower complication rates (p<0.02). Hematoma formation (3.7%) was the most common complication, and there was one death. More than 10% of patients were obese. Brachial plexus injury and axillary skin flap perforations were reported in <1% of cases. Mean cost for a total RT was $13,287 ($5,125-42,444).
  
  
  CONCLUSIONS
  From 2009 through early 2011, there was a steady increase in RT volume, especially among high-volume institutions. In mid-to-late 2011, there was a noticeable drop in RT volume, which significantly altered the projected trajectory of the procedure in this country. Despite higher complication rates, lower-volume centers perform the majority of RT and are also responsible for recent increases in RT utilization patterns in the United States.
authors.affiliation: 1 Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences (UAMS) , Little Rock, Arkansas.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Hinson
authors.affiliation: 2 Department of Surgery, Tulane University School of Medicine , New Orleans, Louisiana.
authors.forename: Emad
authors.initials: E
authors.lastname: Kandil
authors.affiliation: 3 Deparment of Hospital Administration, Oregon Health Sciences University , Portland, Oregon.
authors.forename: Stephanie
authors.initials: S
authors.lastname: O'Brien
authors.affiliation: 4 Department of Biostatistics, University of Arkansas for Medical Sciences (UAMS) , Little Rock, Arkansas.
authors.forename: Horace J
authors.initials: HJ
authors.lastname: Spencer
authors.affiliation: 5 Department of Geriatrics, University of Arkansas for Medical Sciences (UAMS) , Little Rock, Arkansas.
authors.forename: Donald L
authors.initials: DL
authors.lastname: Bodenner
authors.affiliation: 6 University HealthSystem Consortium (UHC) and Department of HealthSystems Management, Chicago, Illinois.
authors.forename: Samuel F
authors.initials: SF
authors.lastname: Hohmann
authors.affiliation: 1 Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences (UAMS) , Little Rock, Arkansas.
authors.forename: Brendan C
authors.initials: BC
authors.lastname: Stack
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla / Q000601:surgery; D001917:Brachial Plexus / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006406:Hematoma / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011379:Prognosis; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000639:trends*; D013961:Thyroid Gland / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects / Q000639:trends*; D014481:United States; D055815:Young Adult