Is robotic hemithyroidectomy comparable to its conventional counterpart?

Abstract

Background: We aimed to examine the outcomes of robot transaxillary thyroidectomy when compared with conventional thyroidectomy in a patient population that lacked the desire for a cervical incision.

Methods: A retrospective review of a prospectively collected database identified all patients who underwent robotic transaxillary hemithyroidectomy between April 2010 and February 2013. The outcomes of these patients were compared with a matched sample of consecutive patients who underwent conventional hemithyroidectomy during the same period. All values are expressed as mean ± standard error of mean.

Results: During the study period, 110 patients underwent robotic transaxillary hemithyroidectomy and were compared to a matched group of 110 patients who underwent conventional hemithyroidectomy. Both groups were similar in regard to body mass index (P = .16) and volume of thyroid lobe resected (P = .71). Patients offered the robotic approach were of younger age (46.4 ± 1 vs 51.9 ± 1.2 years; P < .001). The average total operative time was longer in the robotic group than in the conventional group (136.5 ± 5.1 vs 110.4 ± 4.9 min, (P < .001). Postoperative complications in both groups were comparable (P > .05 for all). In the robotic group, 82.3% of patients were discharged on the same day of the procedure compared to 34.5% in the conventional group (P < .001). There were no instances of permanent vocal fold palsy on postoperative laryngoscopy in any patients.

Conclusion: Robotic hemithyroidectomy is a safe and acceptable surgical approach for appropriately selected patients with thyroid disease. Further studies with prospective multicenter clinical trials will enable us to improve patient selection, techniques, and outcomes and to achieve better patient satisfaction.