New Approach to Thyroid Surgery Eliminates Neck Scar

Researchers at Yonsei University College of Medicine (Seoul, South Korea) have reported their experience of a consecutive series of 1,000 patients with thyroid cancer who underwent robotic thyroidectomy from October 2007 to November 2009 treated using a gasless TAA. All patients were selected using predetermined inclusion criteria after considering surgical risk, and all procedures were completed using the da Vinci surgical system, a product of Intuitive Surgical (Sunnyvale, CA, USA). The patient’s clinicopathologic characteristics, operation types, operation times, numbers of retrieved lymph nodes (LNs), postoperative hospital stays, complications, and short-term follow-up results were analyzed.

The results showed that 627 patients underwent less than total, and 373 patients underwent bilateral total thyroidectomy. Ipsilateral central compartment node dissection was conducted in all 1,000 cases, and additional lateral neck node dissection was conducted in 36 of the 1,000 patients. The mean operation time was 136 minutes, and mean postoperative hospital stay was 3 days. No serious postoperative complication occurred, except three cases of recurrent laryngeal nerve injury, and one case of Horner syndrome. Mean tumor size was 0.79 centimeter, and papillary thyroid microcarcinoma was present in 752 cases (75.5%). According to tumor nodes metastasis staging, 847 patients (84.7%) were of stage I, 144 patients (14.4%) were of stage III, and 9 patients (0.9%) were of stage IVA. The study was published in the August 2011 issue of Surgical Laporoscopy, Endoscopy & Percutaneous Techniques.

“Robotic thyroidectomy using a gasless TAA is a feasible, safe, and promising surgical alternative for selected patients with low-risk thyroid cancer,” concluded lead author Seong-Woong Kang, MD, and colleagues of the department of surgery. “We recommend that the inclusion criteria of this technique be gradually extended to advanced thyroid cancer given suitable operator experience and future developments in robotic systems and instrumentation.”

Thyroidectomy involves the surgical removal of all or part of the thyroid gland due to cancer or some other condition of the thyroid gland, such as hyperthyroidism. Other indications for surgery include cosmetic reasons or symptomatic obstruction causing difficulties in swallowing or breathing. One of the complications of thyroidectomy is voice change, and patients are strongly advised to request protection of the voice by using electronic nerve monitoring. Most thyroidectomies are now performed by minimally invasive surgery using a cut in the neck of no more than 2.5 centimeters.
Source: hospimedica

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