Application progress of da Vinci robot <i>via</i> different approaches in thyroidectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CHEN Chao ^1,2 , YU Jianping ³ , MA Youwei ³ , CHEN Weikai ³ , LU Shunli ² , LI Andong ² , HE Qingyuan ² ,  HAN Xiaopeng ²

1. The First Clinical Medical College of Gansu University of Traditional Chinese Medicine, Lanzhou 730000, P. R. China;
2. Department of General Surgery, 940th Hospital of Joint Service Support Force of Chinese People’s Liberation Army, Lanzhou 730050, P. R. China;
3. Department of General Surgery, Gansu Provincial Central Hospital, Lanzhou 730070, P. R. China;

Corresponding author：

HAN Xiaopeng, Email: hanxiaopeng74@163.com

Keywords：

da Vinci robotic surgery system; thyroidectomy; surgical approach

DOI：

10.7507/1007-9424.202112064

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To summarize the advantages and disadvantages of different surgical approaches in thyroidectomy using the da Vinci robotic surgical system. Method The relevant to articles about da Vinci robotic thyroidectomy via different surgical approaches at home and abroad were retrieved and reviewed. Results The robot-assisted transaxillary thyroidectomy had a definite curative effect and was a mature technology. The bilateral axillary-breast approach thyroidectomy had a wide range of applications and was suitable for beginners. The robotic retroauricular approach thyroidectomy had great advantages in the dissection of lateral cervical lymph nodes. The transoral robotic thyroidectomy was a surgical approach that conformed to the minimally invasive concept. Conclusions Da Vinci robotic thyroidectomy via different surgical approaches has its corresponding application scope and advantages. Clinical surgeons should choose an optimal surgical approach according to the tumor location, size and number of patients and the advantages of the operator, so as to achieve the therapeutic effect of radical cure of tumors and reduction of injury.

Citation： CHEN Chao, YU Jianping, MA Youwei, CHEN Weikai, LU Shunli, LI Andong, HE Qingyuan, HAN Xiaopeng. Application progress of da Vinci robot via different approaches in thyroidectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(8): 1095-1100. doi: 10.7507/1007-9424.202112064 Copy

1.	Nell S, Kist JW, Debray TP, et al. Qualitative elastography can replace thyroid nodule fine-needle aspiration in patients with soft thyroid nodules. A systematic review and meta-analysis. Eur J Radiol, 2015, 84(4): 652-661.
2.	任玲, 罗渝昆, 宋青, 等. 超声造影及弹性成像技术对超声造影无增强甲状腺结节良恶性的鉴别诊断价值. 中华医学超声杂志(电子版), 2020, 17(6): 552-557.
3.	Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
4.	刘宗超, 李哲轩, 张阳, 等. 2020全球癌症统计报告解读. 肿瘤综合治疗电子杂志, 2021, 7(2): 1-14.
5.	Matteucci V, Bai D, Fregoli L, et al. The effect of robot-assisted transaxillary thyroidectomy (RATT) on body image is better than the conventional approach with cervicotomy: a preliminary report. Updates Surg, 2021, 73(3): 1169-1175.
6.	王海伶, 张玲. 新应用领域的机器人医疗外科机器人研究. 电脑编程技巧与维护, 2021, (2): 123-124,143.
7.	Lobe TE, Wright SK, Irish MS. Novel uses of surgical robotics in head and neck surgery. J Laparoendosc Adv Surg Tech A, 2005, 15(6): 647-652.
8.	Kang SW, Jeong JJ, Nam KH, et al. Robot-assisted endoscopic thyroidectomy for thyroid malignancies using a gasless transaxillary approach. J Am Coll Surg, 2009, 209(2): e1-e7. doi: 10.1016/j.jamcollsurg.2009.05.003.
9.	Tae K. Robotic thyroid surgery. Auris Nasus Larynx, 2021, 48(3): 331-338.
10.	李秀萍, 俞红梅, 徐志伟, 等. 改良无充气经腋窝腔镜甲状腺手术治疗甲状腺微小乳头状癌的疗效分析. 中华内分泌外科杂志, 2021, 15(3): 273-277.
11.	Zheng G, Xu J, Wu G, et al. Transoral versus gasless transaxillary endoscopic thyroidectomy: a comparative study. Updates Surg, 2021 Apr 29. doi: 10.1007/s13304-021-01062-y.
12.	Dabas S, Gupta K, Bhakuni YS, et al. Feasibility, safety, and surgical outcome of robotic hemithyroidectomy via transaxillary and retroauricular approach: an institutional experience. Indian J Surg Oncol, 2018, 9(4): 477-482.
13.	Chang EHE, Kim HY, Koh YW, et al. Overview of robotic thyroidectomy. Gland Surg, 2017, 6(3): 218-228.
14.	Bhatia P, Mohamed HE, Kadi A, et al. Remote access thyroid surgery. Gland Surg, 2015, 4(5): 376-387.
15.	Piccoli M, Mullineris B, Gozzo D, et al. Evolution strategies in transaxillary robotic thyroidectomy: considerations on the first 449 cases performed. J Laparoendosc Adv Surg Tech A, 2019, 29(4): 433-440.
16.	Fregoli L, Rossi L, Papini P, et al. Robotic transaxillary thyroidectomy: state of the art. Gland Surg, 2020, 9(Suppl 1): S61-S64. doi: 10.21037/gs.2019.10.11.
17.	Rossi L, Materazzi G, Bakkar S, et al. Recent trends in surgical approach to thyroid cancer. Front Endocrinol (Lausanne), 2021, 12: 699805. doi: 10.3389/fendo.2021.699805.
18.	Pavlidis ET, Psarras KK, Symeonidis NG, et al. Robot-assisted thyroidectomy versus open thyroidectomy in the treatment of well differentiated thyroid carcinoma. JSLS, 2021, 25(3): e2021.00032. doi: 10.4293/JSLS.2021.00032.
19.	Lee DW, Ko SH, Song CM, et al. Comparison of postoperative cosmesis in transaxillary, postauricular facelift, and conventional transcervical thyroidectomy. Surg Endosc, 2020, 34(8): 3388-3397.
20.	Kim MJ, Nam KH, Lee SG, et al. Yonsei experience of 5 000 gasless transaxillary robotic thyroidectomies. World J Surg, 2018, 42(2): 393-401.
21.	Kang SW, Lee SC, Lee SH, et al. Robotic thyroid surgery using a gasless, transaxillary approach and the da Vinci S system: the operative outcomes of 338 consecutive patients. Surgery, 2009, 146(6): 1048-1055.
22.	Berber E, Bernet V, Fahey TJ, et al. American thyroid association statement on remote-access thyroid surgery. Thyroid, 2016, 26(3): 331-337.
23.	Tae K, Ji YB, Song CM, et al. Robotic and endoscopic thyroid surgery: evolution and advances. Clin Exp Otorhinolaryngol, 2019, 12(1): 1-11.
24.	Huang S, Garstka ME, Murcy MA, et al. Somatosensory evoked potential: preventing brachial plexus injury in transaxillary robotic surgery. Laryngoscope, 2019, 129(11): 2663-2668.
25.	Lee KE, Koo do H, Kim SJ, et al. Outcomes of 109 patients with papillary thyroid carcinoma who underwent robotic total thyroidectomy with central node dissection via the bilateral axillo-breast approach. Surgery, 2010, 148(6): 1207-1213.
26.	Lee KE, Kim E, Koo do H, et al. Robotic thyroidectomy by bilateral axillo-breast approach: review of 1 026 cases and surgical completeness. Surg Endosc, 2013, 27(8): 2955-2962.
27.	Lee KE, Choi JY, Youn YK. Bilateral axillo-breast approach robotic thyroidectomy. Surg Laparosc Endosc Percutan Tech, 2011, 21(4): 230-236.
28.	Seup Kim B, Kang KH, Park SJ. Robotic modified radical neck dissection by bilateral axillary breast approach for papillary thyroid carcinoma with lateral neck metastasis. Head Neck, 2015, 37(1): 37-45.
29.	Chai YJ, Kim HY, Kim HK, et al. Comparative analysis of 2 robotic thyroidectomy procedures: transoral versus bilateral axillo-breast approach. Head Neck, 2018, 40(5): 886-892.
30.	Sun HX, Gao HJ, Ying XY, et al. Robotic thyroidectomy via bilateral axillo-breast approach: experience and learning curve through initial 220 cases. Asian J Surg, 2020, 43(3): 482-487.
31.	Liu SY, Kim JS. Bilateral axillo-breast approach robotic thyroidectomy: review of evidences. Gland Surg, 2017, 6(3): 250-257.
32.	Lee KE, Rao J, Youn YK. Endoscopic thyroidectomy with the da Vinci robot system using the bilateral axillary breast approach (BABA) technique: our initial experience. Surg Laparosc Endosc Percutan Tech, 2009, 19(3): e71-e75. doi: 10.1097/SLE.0b013e3181a4ccae.
33.	Liu SY, Ng EK. Robotic versus open thyroidectomy for differentiated thyroid cancer: an evidence-based review. Int J Endocrinol, 2016, 2016: 4309087. doi: 10.1155/2016/4309087.
34.	Terris DJ, Singer MC, Seybt MW. Robotic facelift thyroidectomy: Ⅱ. Clinical feasibility and safety. Laryngoscope, 2011, 121(8): 1636-1641.
35.	Byeon HK, Holsinger FC, Tufano RP, et al. Robotic total thyroidectomy with modified radical neck dissection via unilateral retroauricular approach. Ann Surg Oncol, 2014, 21(12): 3872-3875.
36.	Singer MC, Seybt MW, Terris DJ. Robotic facelift thyroidectomy: Ⅰ. Preclinical simulation and morphometric assessment. Laryngoscope, 2011, 121(8): 1631-1635.
37.	Lee DY, Baek SK, Jung KY. Endoscopic thyroidectomy: retroauricular approach. Gland Surg, 2016, 5(3): 327-335.
38.	Song CM, Kim MS, Lee DW, et al. Comparison of postoperative voice outcomes after postauricular facelift robotic hemithyroidectomy and conventional transcervical hemithyroidectomy. Head Neck, 2019, 41(9): 2921-2928.
39.	Song CM, Park JS, Park HJ, et al. Voice outcomes of transoral robotic thyroidectomy: comparison with conventional trans-cervical thyroidectomy. Oral Oncol, 2020, 107: 104748. doi: 10.1016/j.oraloncology.2020.104748.
40.	de Vries LH, Aykan D, Lodewijk L, et al. Outcomes of minimally invasive thyroid surgery—A systematic review and meta-analysis. Front Endocrinol (Lausanne), 2021, 12: 719397. doi: 10.3389/fendo.2021.719397.
41.	Lee DW, Bang HS, Jeong JH, et al. Cosmetic outcomes after transoral robotic thyroidectomy: comparison with transaxillary, postauricular, and conventional approaches. Oral Oncol, 2021, 114: 105139. doi: 10.1016/j.oraloncology.2020.105139.
42.	Lee HY, You JY, Woo SU, et al. Transoral periosteal thyroidectomy: cadaver to human. Surg Endosc, 2015, 29(4): 898-904.
43.	Richmon JD, Holsinger FC, Kandil E, et al. Transoral robotic-assisted thyroidectomy with central neck dissection: preclinical cadaver feasibility study and proposed surgical technique. J Robot Surg, 2011, 5(4): 279-282.
44.	Kim HY, Chai YJ, Dionigi G, et al. Transoral robotic thyroidectomy: lessons learned from an initial consecutive series of 24 patients. Surg Endosc, 2018, 32(2): 688-694.
45.	Richmon JD, Kim HY. Transoral robotic thyroidectomy (TORT): procedures and outcomes. Gland Surg, 2017, 6(3): 285-289.
46.	Zhang D, Park D, Sun H, et al. Indications, benefits and risks of transoral thyroidectomy. Best Pract Res Clin Endocrinol Metab, 2019, 33(4): 101280. doi: 10.1016/j.beem.2019.05.004.
47.	Kim HY, Park D, Bertelli AAT. The pros and cons of additional axillary arm for transoral robotic thyroidectomy. World J Otorhinolaryngol Head Neck Surg, 2020, 6(3): 161-164.
48.	Chan JYK, Koh YW, Richmon J, et al. Transoral thyroidectomy with a next generation flexible robotic system: a feasibility study in a cadaveric model. Gland Surg, 2019, 8(6): 644-647.
49.	Tae K. Transoral robotic thyroidectomy using the da Vinci single-port surgical system. Gland Surg, 2020, 9(3): 614-616.
50.	Park YM, Kim DH, Moon YM, et al. Gasless transoral robotic thyroidectomy using the DaVinci SP system: feasibility, safety, and operative technique. Oral Oncol, 2019, 95: 136-142.
51.	Tai DKC, Kim HY, Park D, et al. Obesity may not affect outcomes of transoral robotic thyroidectomy: subset analysis of 304 patients. Laryngoscope, 2020, 130(5): 1343-1348.
52.	Russell JO, Razavi CR, Al Khadem MG, et al. Anterior cervical incision-sparing thyroidectomy: comparing retroauricular and transoral approaches. Laryngoscope Investig Otolaryngol, 2018, 3(5): 409-414.

1. Nell S, Kist JW, Debray TP, et al. Qualitative elastography can replace thyroid nodule fine-needle aspiration in patients with soft thyroid nodules. A systematic review and meta-analysis. Eur J Radiol, 2015, 84(4): 652-661.
2. 任玲, 罗渝昆, 宋青, 等. 超声造影及弹性成像技术对超声造影无增强甲状腺结节良恶性的鉴别诊断价值. 中华医学超声杂志(电子版), 2020, 17(6): 552-557.
3. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
4. 刘宗超, 李哲轩, 张阳, 等. 2020全球癌症统计报告解读. 肿瘤综合治疗电子杂志, 2021, 7(2): 1-14.
5. Matteucci V, Bai D, Fregoli L, et al. The effect of robot-assisted transaxillary thyroidectomy (RATT) on body image is better than the conventional approach with cervicotomy: a preliminary report. Updates Surg, 2021, 73(3): 1169-1175.
6. 王海伶, 张玲. 新应用领域的机器人医疗外科机器人研究. 电脑编程技巧与维护, 2021, (2): 123-124,143.
7. Lobe TE, Wright SK, Irish MS. Novel uses of surgical robotics in head and neck surgery. J Laparoendosc Adv Surg Tech A, 2005, 15(6): 647-652.
8. Kang SW, Jeong JJ, Nam KH, et al. Robot-assisted endoscopic thyroidectomy for thyroid malignancies using a gasless transaxillary approach. J Am Coll Surg, 2009, 209(2): e1-e7. doi: 10.1016/j.jamcollsurg.2009.05.003.
9. Tae K. Robotic thyroid surgery. Auris Nasus Larynx, 2021, 48(3): 331-338.
10. 李秀萍, 俞红梅, 徐志伟, 等. 改良无充气经腋窝腔镜甲状腺手术治疗甲状腺微小乳头状癌的疗效分析. 中华内分泌外科杂志, 2021, 15(3): 273-277.
11. Zheng G, Xu J, Wu G, et al. Transoral versus gasless transaxillary endoscopic thyroidectomy: a comparative study. Updates Surg, 2021 Apr 29. doi: 10.1007/s13304-021-01062-y.
12. Dabas S, Gupta K, Bhakuni YS, et al. Feasibility, safety, and surgical outcome of robotic hemithyroidectomy via transaxillary and retroauricular approach: an institutional experience. Indian J Surg Oncol, 2018, 9(4): 477-482.
13. Chang EHE, Kim HY, Koh YW, et al. Overview of robotic thyroidectomy. Gland Surg, 2017, 6(3): 218-228.
14. Bhatia P, Mohamed HE, Kadi A, et al. Remote access thyroid surgery. Gland Surg, 2015, 4(5): 376-387.
15. Piccoli M, Mullineris B, Gozzo D, et al. Evolution strategies in transaxillary robotic thyroidectomy: considerations on the first 449 cases performed. J Laparoendosc Adv Surg Tech A, 2019, 29(4): 433-440.
16. Fregoli L, Rossi L, Papini P, et al. Robotic transaxillary thyroidectomy: state of the art. Gland Surg, 2020, 9(Suppl 1): S61-S64. doi: 10.21037/gs.2019.10.11.
17. Rossi L, Materazzi G, Bakkar S, et al. Recent trends in surgical approach to thyroid cancer. Front Endocrinol (Lausanne), 2021, 12: 699805. doi: 10.3389/fendo.2021.699805.
18. Pavlidis ET, Psarras KK, Symeonidis NG, et al. Robot-assisted thyroidectomy versus open thyroidectomy in the treatment of well differentiated thyroid carcinoma. JSLS, 2021, 25(3): e2021.00032. doi: 10.4293/JSLS.2021.00032.
19. Lee DW, Ko SH, Song CM, et al. Comparison of postoperative cosmesis in transaxillary, postauricular facelift, and conventional transcervical thyroidectomy. Surg Endosc, 2020, 34(8): 3388-3397.
20. Kim MJ, Nam KH, Lee SG, et al. Yonsei experience of 5 000 gasless transaxillary robotic thyroidectomies. World J Surg, 2018, 42(2): 393-401.
21. Kang SW, Lee SC, Lee SH, et al. Robotic thyroid surgery using a gasless, transaxillary approach and the da Vinci S system: the operative outcomes of 338 consecutive patients. Surgery, 2009, 146(6): 1048-1055.
22. Berber E, Bernet V, Fahey TJ, et al. American thyroid association statement on remote-access thyroid surgery. Thyroid, 2016, 26(3): 331-337.
23. Tae K, Ji YB, Song CM, et al. Robotic and endoscopic thyroid surgery: evolution and advances. Clin Exp Otorhinolaryngol, 2019, 12(1): 1-11.
24. Huang S, Garstka ME, Murcy MA, et al. Somatosensory evoked potential: preventing brachial plexus injury in transaxillary robotic surgery. Laryngoscope, 2019, 129(11): 2663-2668.
25. Lee KE, Koo do H, Kim SJ, et al. Outcomes of 109 patients with papillary thyroid carcinoma who underwent robotic total thyroidectomy with central node dissection via the bilateral axillo-breast approach. Surgery, 2010, 148(6): 1207-1213.
26. Lee KE, Kim E, Koo do H, et al. Robotic thyroidectomy by bilateral axillo-breast approach: review of 1 026 cases and surgical completeness. Surg Endosc, 2013, 27(8): 2955-2962.
27. Lee KE, Choi JY, Youn YK. Bilateral axillo-breast approach robotic thyroidectomy. Surg Laparosc Endosc Percutan Tech, 2011, 21(4): 230-236.
28. Seup Kim B, Kang KH, Park SJ. Robotic modified radical neck dissection by bilateral axillary breast approach for papillary thyroid carcinoma with lateral neck metastasis. Head Neck, 2015, 37(1): 37-45.
29. Chai YJ, Kim HY, Kim HK, et al. Comparative analysis of 2 robotic thyroidectomy procedures: transoral versus bilateral axillo-breast approach. Head Neck, 2018, 40(5): 886-892.
30. Sun HX, Gao HJ, Ying XY, et al. Robotic thyroidectomy via bilateral axillo-breast approach: experience and learning curve through initial 220 cases. Asian J Surg, 2020, 43(3): 482-487.
31. Liu SY, Kim JS. Bilateral axillo-breast approach robotic thyroidectomy: review of evidences. Gland Surg, 2017, 6(3): 250-257.
32. Lee KE, Rao J, Youn YK. Endoscopic thyroidectomy with the da Vinci robot system using the bilateral axillary breast approach (BABA) technique: our initial experience. Surg Laparosc Endosc Percutan Tech, 2009, 19(3): e71-e75. doi: 10.1097/SLE.0b013e3181a4ccae.
33. Liu SY, Ng EK. Robotic versus open thyroidectomy for differentiated thyroid cancer: an evidence-based review. Int J Endocrinol, 2016, 2016: 4309087. doi: 10.1155/2016/4309087.
34. Terris DJ, Singer MC, Seybt MW. Robotic facelift thyroidectomy: Ⅱ. Clinical feasibility and safety. Laryngoscope, 2011, 121(8): 1636-1641.
35. Byeon HK, Holsinger FC, Tufano RP, et al. Robotic total thyroidectomy with modified radical neck dissection via unilateral retroauricular approach. Ann Surg Oncol, 2014, 21(12): 3872-3875.
36. Singer MC, Seybt MW, Terris DJ. Robotic facelift thyroidectomy: Ⅰ. Preclinical simulation and morphometric assessment. Laryngoscope, 2011, 121(8): 1631-1635.
37. Lee DY, Baek SK, Jung KY. Endoscopic thyroidectomy: retroauricular approach. Gland Surg, 2016, 5(3): 327-335.
38. Song CM, Kim MS, Lee DW, et al. Comparison of postoperative voice outcomes after postauricular facelift robotic hemithyroidectomy and conventional transcervical hemithyroidectomy. Head Neck, 2019, 41(9): 2921-2928.
39. Song CM, Park JS, Park HJ, et al. Voice outcomes of transoral robotic thyroidectomy: comparison with conventional trans-cervical thyroidectomy. Oral Oncol, 2020, 107: 104748. doi: 10.1016/j.oraloncology.2020.104748.
40. de Vries LH, Aykan D, Lodewijk L, et al. Outcomes of minimally invasive thyroid surgery—A systematic review and meta-analysis. Front Endocrinol (Lausanne), 2021, 12: 719397. doi: 10.3389/fendo.2021.719397.
41. Lee DW, Bang HS, Jeong JH, et al. Cosmetic outcomes after transoral robotic thyroidectomy: comparison with transaxillary, postauricular, and conventional approaches. Oral Oncol, 2021, 114: 105139. doi: 10.1016/j.oraloncology.2020.105139.
42. Lee HY, You JY, Woo SU, et al. Transoral periosteal thyroidectomy: cadaver to human. Surg Endosc, 2015, 29(4): 898-904.
43. Richmon JD, Holsinger FC, Kandil E, et al. Transoral robotic-assisted thyroidectomy with central neck dissection: preclinical cadaver feasibility study and proposed surgical technique. J Robot Surg, 2011, 5(4): 279-282.
44. Kim HY, Chai YJ, Dionigi G, et al. Transoral robotic thyroidectomy: lessons learned from an initial consecutive series of 24 patients. Surg Endosc, 2018, 32(2): 688-694.
45. Richmon JD, Kim HY. Transoral robotic thyroidectomy (TORT): procedures and outcomes. Gland Surg, 2017, 6(3): 285-289.
46. Zhang D, Park D, Sun H, et al. Indications, benefits and risks of transoral thyroidectomy. Best Pract Res Clin Endocrinol Metab, 2019, 33(4): 101280. doi: 10.1016/j.beem.2019.05.004.
47. Kim HY, Park D, Bertelli AAT. The pros and cons of additional axillary arm for transoral robotic thyroidectomy. World J Otorhinolaryngol Head Neck Surg, 2020, 6(3): 161-164.
48. Chan JYK, Koh YW, Richmon J, et al. Transoral thyroidectomy with a next generation flexible robotic system: a feasibility study in a cadaveric model. Gland Surg, 2019, 8(6): 644-647.
49. Tae K. Transoral robotic thyroidectomy using the da Vinci single-port surgical system. Gland Surg, 2020, 9(3): 614-616.
50. Park YM, Kim DH, Moon YM, et al. Gasless transoral robotic thyroidectomy using the DaVinci SP system: feasibility, safety, and operative technique. Oral Oncol, 2019, 95: 136-142.
51. Tai DKC, Kim HY, Park D, et al. Obesity may not affect outcomes of transoral robotic thyroidectomy: subset analysis of 304 patients. Laryngoscope, 2020, 130(5): 1343-1348.
52. Russell JO, Razavi CR, Al Khadem MG, et al. Anterior cervical incision-sparing thyroidectomy: comparing retroauricular and transoral approaches. Laryngoscope Investig Otolaryngol, 2018, 3(5): 409-414.

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Application progress of da Vinci robot via different approaches in thyroidectomy

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