Robotic transaxillary thyroidectomy: time to expand indications?

J Robot Surg. 2023 Aug;17(4):1777-1785. doi: 10.1007/s11701-023-01594-y. Epub 2023 Apr 17.

Abstract

In 2016, the American Thyroid Association published a statement on remote-access thyroid surgery claiming that it should be reserved to patients with thyroid nodule ≤ 3 cm, thyroid lobe < 6 cm and without thyroiditis. We retrospectively enrolled all patients who underwent robotic transaxillary thyroidectomy between February 2012 and March 2022. We compared surgical outcomes between patients who presented a thyroid gland with a nodule ≤ 3 cm, thyroid lobe < 6 cm and without thyroiditis (Group A) and patients without these features (Group B). The rate of overall complications resulted comparable (p = 0.399), as well as the operative time (p = 0.477) and the hospital stay (p = 0.305). Moreover, bleeding resulted associated to thyroid nodule > 3 cm (p = 0.015), although all bleedings but one occurred in the remote-access site from the axilla to the neck. In experienced hands, robotic transaxillary thyroidectomy is feasible and safe even in patients with large thyroid nodules or thyroiditis.

Keywords: Remote-access thyroidectomy; Robot-assisted surgery; Robotic transaxillary thyroidectomy; Thyroid; Thyroidectomy.

MeSH terms

  • Axilla / surgery
  • Humans
  • Operative Time
  • Retrospective Studies
  • Robotic Surgical Procedures* / methods
  • Thyroid Nodule* / etiology
  • Thyroid Nodule* / surgery
  • Thyroidectomy / adverse effects
  • Thyroidectomy / methods
  • Thyroiditis* / etiology
  • Thyroiditis* / surgery
  • Treatment Outcome