Recent advances and considerations about robotic thyroidectomy / 中华内分泌外科杂志

Robotic thyroidectomy (RT) system combines the advantages of the surgical robot and remote access thyroidectomy,provides the benefits of excellent three-dimensional visualization,stable operative view and improved surgical dexterity,has been applied in clinical practices for 10 years and proved to have comparable surgical safety and oncological completeness with traditional open operation,and provides smaller surgical injury (psychological and physical injury),better functional protection (including neck function,parathyroid glands and laryngeal nerve),and significantly higher cosmetic satisfaction.There are two mostly common used RT approaches,bilateral axillobreast approach (BABA) and transaxillary approach (TAA).Since surgeons accumulate more experience,the indications of RT have been expanded to differentiated thyroid cancer with tumor size between 2-4 cm with (or without) lateral neck lymph node metastases by far.To date,all related studies are nonrandomized or retrospective comparisons.It's necessary to launch multi-centers randomized studies and long term follow-up to offer higher evidence to boost the future application of RT.

Comparison of robotic thyroidectomy through the trans-axillary and the anterior chest approach in a por-cine model / 中华内分泌外科杂志

Objective To evaluate the safety of the da Vinci Si surgical system in thyroid surgery and to accumulate operation experience .Methods The da Vinci Si surgical system consists of a surgeon's console, a patient-side robotic cart, and high-definition 3D vision system.The robot arm tips were introduced via a single axillary incision or small chest wall ports and attached to the arms of the robot .The surgeon , sitting at the con-sole, manipulated the EndoWrist instruments and endoscope view that transfer the surgeon 's movements to the arm tips.The so called EndoWrist'technology offers seven degrees of movements ( up, down, left, right, twist, et al) , thus exceeding the capacity of a surgeon's hand in open surgery .The da Vinci Si surgical system was used to perform thyroidectomy in two small pigs .The animals were intubated and kept anesthetized with halothane .Re-sults Four surgical procedures were done using the da Vinci Si system from beginning to the end , including 2 thyroidectomies and 2 thymectomies .No conversions to open or laparoscopic procedure was used .The procedure length was 61 minutes and 50 minutes, respectively.Conclusions Robotic thyroidectomy can be performed safe-ly by the experienced surgeons after short-term da Vinci Si surgical system training .The learning curve for robotic thyroidectomy is shorter .