Application and advantages of a joystick-controlled robotic scope holder in transoral endoscopic thyroidectomy vestibular approach: a comparative study

Suo-Hsien Wang; Tsai-Heng Hsieh; Wu-Po Chao; Ta-You Lo; Ting-Shuo Huang; Yu-Hsien Chen

doi:10.1007/s13304-024-01783-w

Application and advantages of a joystick-controlled robotic scope holder in transoral endoscopic thyroidectomy vestibular approach: a comparative study

Updates Surg. 2024 Mar 11. doi: 10.1007/s13304-024-01783-w. Online ahead of print.

Authors

Suo-Hsien Wang¹, Tsai-Heng Hsieh¹, Wu-Po Chao¹, Ta-You Lo², Ting-Shuo Huang¹, Yu-Hsien Chen³

Affiliations

¹ Department of General Surgery, Chang Gung Memorial Hospital, No. 222, Maijin Rd., Anle Dist., Keelung, 204, Taiwan.
² Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Keelung, Taiwan.
³ Department of General Surgery, Chang Gung Memorial Hospital, No. 222, Maijin Rd., Anle Dist., Keelung, 204, Taiwan. capitatecapitate@gmail.com.

PMID: 38468019
DOI: 10.1007/s13304-024-01783-w

Abstract

Transoral endoscopic thyroidectomy has gained popularity due to its scarless nature, but the use of a handheld endoscope can lead to an unstable visual field. Soloassist II, a robotic scope holder, enables precise control using a joystick, ensuring stable vision. This study aims to evaluate the application and the advantages of Soloassist II in transoral thyroidectomy. Patients who underwent transoral thyroidectomy with Soloassist II or human assistance between June 2019 and May 2021 were reviewed. Patient demographics and surgical outcomes were compared. The ergonomic stress of the assistant in both groups was also measured. A total of 100 consecutive patients were included: 32 were assisted by Soloassist II and 68 by humans. The Soloassist II group demonstrated significantly shorter operation times (median [IQR]) (165 [149,179] vs. 181 [165,204] min, P = 0.004) in unilateral lobectomy and less blood loss (median [IQR]) (2 [2,2] vs. 2 [2,3] ml, P = 0.002) than the human-assisted group. Postoperative course and complication rates were similar. The musculoskeletal pain of the assistant was significantly higher and involved more areas in the human-assisted group. The utilization of Soloassist II in transoral endoscopic thyroidectomy is easy to set up and leads to shorter operation times, reduced blood loss, and decreased musculoskeletal pain compared to human handheld endoscope. These findings support the potential of Soloassist II in improving surgical outcomes and minimizing physical strain during transoral thyroidectomy.

Keywords: Ergonomics in surgery; Joystick-controlled robotic scope holder; Robotic scope holder; Scope holder; TOETVA; Transoral endoscopic thyroidectomy.