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  • Title: Robotic transaxillary thyroid lobectomy of a follicular neoplasm.
    Author: Massasati S, Noureldine S, Aslam R, Kandil E.
    Journal: Ann Surg Oncol; 2012 Jul; 19(7):2310. PubMed ID: 22407311.
    Abstract:
    PURPOSE: Minimally invasive thyroid surgery using various techniques is well described. The purpose of this video is to show a robotic-assisted transaxillary right thyroid lobectomy for a follicular neoplasm with intraoperative nerve monitoring and stimulation of recurrent laryngeal nerve. Herein, we show our experience with the technique and its safety and feasibility. METHODS: We performed a right thyroid lobectomy on a 33-year-old patient using the da Vinci-Si-HD Surgical System. The operation was done via a single axillary incision, 5 cm in length. The flap creation time was approximately 26 min. The robot docking time was 6 min. The recurrent laryngeal nerve was identified and nerve stimulation was used to stimulate with 0.5 milliamps. The operative console time was 21 min. Total operative time was 69 min. RESULTS: The procedure was successfully completed. Blood loss was minimal. Postoperative laryngoscopy showed intact and mobile bilateral vocal cords. There were no complications. Patient was discharged 4 h after surgery. CONCLUSIONS: Robotic transaxillary endoscopic gasless thyroid surgery with monitoring and stimulation of the RLN is feasible and safe. This technique eliminates a visible neck scar and affords excellent high definition optics of the cervical anatomy. This new technique can be accomplished on an outpatient basis.
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