title: Remote Access Robotic Facelift Thyroidectomy: A Multi-institutional Experience.
abstract: Robotic facelift thyroidectomy (RFT) was developed as a new surgical approach to the thyroid gland using a remote incision site. Early favorable results led to this confirmatory multi-institutional experience.
  
  
  
  Prospectively collected data on consecutive patients undergoing RFT in five North American academic endocrine surgical practices were compiled. Surgical indications, operative times, final pathology, nodule size, complications, and postoperative management (drain use and length of hospital stay) were evaluated.
  
  
  
  A total of 102 RFT procedures were undertaken in 90 patients. All but one of the patients (98.9 %) were female, and the mean age was 41.9 ± 13.1 years (range 12-69 years). The indication for surgery was nodular disease in 91.2 % of cases; 8.8 % were completion procedures performed for a diagnosis of cancer. The mean size of the largest nodule was 1.9 cm (range 0-5.6 cm). The mean total operative time for a thyroid lobectomy was 162 min (range 82-265 min). No permanent complications occurred. There were 4 cases (3.9 %) of transient recurrent laryngeal nerve weakness, no cases of hypocalcemia, and 3 (2.9 %) hematomas. There were no conversions to an anterior cervical approach. The majority of patients were managed on an outpatient basis (61.8 %) and without a drain (65.7 %).
  
  
  
  RFT is technically feasible and safe in selected patients. RFT can continue to be offered to carefully selected patients as a way to avoid a visible cervical scar. Future prospective studies to compare this novel approach to other remote access approaches are warranted.
authors.affiliation: Department of Otolaryngology and Endocrinology, Augusta University Thyroid and Parathyroid Center, Augusta University, 1120 Fifteenth Street, BP-4109, Augusta, GA, 30912-4060, USA.
authors.forename: William S
authors.initials: WS
authors.lastname: Duke
authors.affiliation: Division of Head and Neck Surgery, Department of Otolaryngology, Stanford University, Palo Alto, CA, USA.
authors.forename: F Christopher
authors.initials: FC
authors.lastname: Holsinger
authors.affiliation: Department of Surgery, Tulane University, New Orleans, LA, USA.
authors.forename: Emad
authors.initials: E
authors.lastname: Kandil
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Richmon
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Henry Ford Health System, West Bloomfield, MI, USA.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Singer
authors.affiliation: Department of Otolaryngology and Endocrinology, Augusta University Thyroid and Parathyroid Center, Augusta University, 1120 Fifteenth Street, BP-4109, Augusta, GA, 30912-4060, USA. dterris@augusta.edu.
authors.forename: David J
authors.initials: DJ
authors.lastname: Terris
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D013959:Thyroid Diseases / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult