First Experience of Single-Port Robotic Areolar Approach Thyroidectomy
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Objectives. Numerous minimally invasive thyroidectomy techniques have been developed and are actively utilized in hos-pitals around the globe. Herein, we describe a recently developed minimally invasive thyroidectomy technique thatemploys the da Vinci SP, and we present the preliminary clinical outcomes of single-port robotic areolar thyroidecto-my (SPRA). Methods. A 3-cm semi-circular incision on the right areola and a small 8-mm incision on the left areola were created. Usinghydro-dissection and an advanced bipolar device, a subcutaneous skin flap was created, extending from the areola tothe thyroid cartilage. The da Vinci SP was then inserted through the incision in the right areola. Between December2022 and March 2023, 21 SPRA procedures were conducted. Patients’ medical records and surgical videos were sub-sequently reviewed. Results. Lobectomy was performed in 17 patients, isthmectomy in 2 patients, and total thyroidectomy in 2 patients. Themean flap time was 14.9±4.2 minutes and the console time was 62.4±17.1 minutes. The mean tumor size was 0.89±0.65 cm and the number of retrieved lymph nodes was 3.94±3.98 (range, 0–12). There were no observed instancesof vocal cord palsy or hypoparathyroidism. Conclusion. We successfully developed and performed the novel SPRA for the first time worldwide. Unlike other roboticsurgery methods, SPRA is less invasive and leaves no visible scars. This technique employs a sophisticated single-portrobotic device. However, to assess the efficacy of this method, we need to analyze more cases and conduct compara-tive studies in the near future.
Abstract
Objectives. Numerous minimally invasive thyroidectomy techniques have been developed and are actively utilized in hos-pitals around the globe. Herein, we describe a recently developed minimally invasive thyroidectomy technique thatemploys the da Vinci SP, and we present the preliminary clinical outcomes of single-port robotic areolar thyroidecto-my (SPRA). Methods. A 3-cm semi-circular incision on the right areola and a small 8-mm incision on the left areola were created. Usinghydro-dissection and an advanced bipolar device, a subcutaneous skin flap was created, extending from the areola tothe thyroid cartilage. The da Vinci SP was then inserted through the incision in the right areola. Between December2022 and March 2023, 21 SPRA procedures were conducted. Patients’ medical records and surgical videos were sub-sequently reviewed. Results. Lobectomy was performed in 17 patients, isthmectomy in 2 patients, and total thyroidectomy in 2 patients. Themean flap time was 14.9±4.2 minutes and the console time was 62.4±17.1 minutes. The mean tumor size was 0.89±0.65 cm and the number of retrieved lymph nodes was 3.94±3.98 (range, 0–12). There were no observed instancesof vocal cord palsy or hypoparathyroidism. Conclusion. We successfully developed and performed the novel SPRA for the first time worldwide. Unlike other roboticsurgery methods, SPRA is less invasive and leaves no visible scars. This technique employs a sophisticated single-portrobotic device. However, to assess the efficacy of this method, we need to analyze more cases and conduct compara-tive studies in the near future.
참고문헌 (28)
- Davies L, "Current thyroid cancer trends in the United States", JAMA Otolaryngol Head Neck Surg, 140(4), pp.317~322 (2014)
- Zhai M, "The global burden of thyroid cancer and its attributable risk factor in 195 countries and territories : a systematic analysis for the Global Burden of Disease Study", Cancer Med, 10(13), pp.4542~4554 (2021)
- "HIRA bigdata open portal" (2022)[URL]
- Randolph GW, "Surgery of the thyroid and parathyroid glands" (2013), Elsevier
- Arora A, "The perception of scar cosmesis following thyroid and parathyroid surgery : a prospective cohort study", Int J Surg, 25, pp.38~43 (2016)
- de Vries LH, "Outcomes of minimally invasive thyroid surgery : a systematic review and meta-analysis", Front Endocrinol(Lausanne), 12, pp.719397~ (2021)
- 태경, "Robotic and Endoscopic Thyroid Surgery: Evolution and Advances", Clinical and Experimental Otorhinolaryngology, 12(1), pp.1~11 (2019), 대한이비인후과학회[DOI]
- Ruhle BC, "Robot-assisted endocrine surgery : indications and drawbacks", J Laparoendosc Adv Surg Tech A, 29(2), pp.129~135 (2019)
- Choe JH, "Endoscopic thyroidectomy using a new bilateral axillo-breast approach", World J Surg, 31(3), pp.601~606 (2007)
- Lee KE, "Endoscopic thyroidectomy with the da Vinci robot system using the bilateral axillary breast approach(BABA)technique : our initial experience", Surg Laparosc Endosc Percutan Tech, 19(3), pp.e71~5 (2009)
- Kwak J, "Bilateral axillo-breast approach robotic thyroid surgery", Ann Robot Innov Surg, 1(2), pp.69~80 (2020)
- Ryu Han Byul, "Harmonic versus LigaSure for Flap Creation in Bilateral Axillary Breast Approach Thyroid Surgery", The Journal of Endocrine Surgery, 20(4), pp.69~77 (2020), 대한내분비외과학회[DOI]
- Choi YS, "Single surgeon experience with 500 cases of the robotic bilateral axillary breast approach(BABA)for thyroid surgery using the Da-Vinci Xi system", J Clin Med, 10(18), pp.4048~ (2021)
- Vaccarella S, "Worldwide thyroid-cancer epidemic? : the increasing impact of overdiagnosis", N Engl J Med, 375(7), pp.614~617 (2016)
- Dordea M, "Short and long-term cosmesis of cervical thyroidectomy scars", Ann R Coll Surg Engl, 98(1), pp.11~17 (2016)
- Qiu TY, "Preoperative scar perception study comparing ‘scarless’ in the neck endoscopic thyroidectomy with open thyroidectomy : a cross-sectional study", Ann R Coll Surg Engl, 102(9), pp.737~743 (2020)
- Kang SW, "Robot-assisted endoscopic surgery for thyroid cancer : experience with the first 100 patients", Surg Endosc, 23(11), pp.2399~2406 (2009)
- Kim MJ, "Yonsei experience of 5000 gasless transaxillary robotic thyroidectomies", World J Surg, 42(2), pp.393~401 (2018)
- Terris DJ, "Robotic facelift thyroidectomy : II. Clinical feasibility and safety", Laryngoscope, 121(8), pp.1636~1641 (2011)
- Richmon JD, "Transoral robotic thyroidectomy(TORT) : procedures and outcomes", Gland Surg, 6(3), pp.285~289 (2017)
- 성찬용, "Oncoplastic Thyroid Surgery Using A Bilateral Axillo-Breast Approach", Journal of Minimally Invasive Surgery, 20(2), pp.51~57 (2017), 대한내시경로봇외과학회
- Kwak J, "A time trend analysis of 5, 000 robotic thyroidectomies via bilateral axillo-breast approach", World J Surg, 47(2), pp.403~411 (2023)
- Kwon H, "Comparison of bilateral axillo-breast approach robotic thyroidectomy with open thyroidectomy for Graves’ disease", World J Surg, 40(3), pp.498~504 (2016)
- Chai YJ, "Surgical safety and oncological completeness of robotic thyroidectomy for thyroid carcinoma larger than 2 cm", Surg Endosc, 31(3), pp.1235~1240 (2017)
- Yu HW, "Robotic-assisted modified radical neck dissection using a bilateral axillo-breast approach(robotic BABA MRND)for papillary thyroid carcinoma with lateral lymph node metastasis", Surg Endosc, 32(5), pp.2322~2327 (2018)
- Lee KE, "Surgical completeness of bilateral axillo-breast approach robotic thyroidectomy : comparison with conventional open thyroidectomy after propensity score matching", Surgery, 150(6), pp.1266~1274 (2011)
- Kim Woochul, "Reduced Port Robotic Bilateral Axillo-Breast Approach (BABA) Isthmusectomy", The Journal of Endocrine Surgery, 21(4), pp.111~117 (2021), 대한내분비외과학회[DOI]
- 윤혜정, "Initial Experience of BABA Robotic Thyroidectomy Using the Da Vinci Xi System in Incheon, Korea", The Journal of Endocrine Surgery, 19(3), pp.59~67 (2019), 대한내분비외과학회[DOI]