Robotic Thyroidectomy: Applicable Surgical Approaches and Clinical Benefit

Chun-Nan Chen ； Tsung-Lin Yang

《International Journal of Head and Neck Science》 1卷2期 (2017/06) Pp. 95-104

https://doi.org/10.6696/IJHNS.2017.0102.02

摘要

Thyroid diseases are clinically common worldwide. Thyroidectomy through a transcervical skin incision had been practiced for centuries because of the advantages of providing sufficient and direct exposure required for surgical procedures. However, leaving an obvious scar over the anterior neck is unavoidable. Recent progress of technological innovation including endoscopy and surgical robotic systems offers the possibility to perform thyroidectomy through remote accesses. It successfully conceals operative scars in less noticeable locations rather than the anterior neck. Surgical robotic systems have the camera with three-dimensional and magnified views, instruments with dexterous movement, and tremor-free and remote control. It is therefore useful to be applied in small and remote surgical fields created for thyroidectomy through remote accesses. To date, several applicable surgical techniques have been developed including transaxillary, axillary-breast, bilateral axillary-breast, postauricular and axillary, facelift, trans-hairline, and transoral approaches. The main purpose of these methods is to offer a safe thyroidectomy without a scar in the anterior neck. Robotic thyroidectomy provides a new alternative to maintain esthetic outcome and significantly improves the quality of life postoperatively. Although drawbacks still exist in the current design of surgical robotic systems including bulky instruments, the steep learning curve, and cost, they may be improved by well-established training curriculum, new devices and instruments, and accumulation of surgical experience. Robotic surgery will potentiate and extend the therapeutic possibility in thyroidectomy after century-long evolution.

關鍵字

esthetics ； robotic surgery ； robotic thyroidectomy ； scarless surgery