ObjectiveTo investigate the voice function before and after surgery in patients undergoing axillary thyroidectomy with da Vinci robotic Xi system. MethodsSeventy female patients who underwent robotic thyroid cancer radical resection in Panzhihua Central Hospital from March 2022 to March 2023 were selected. The voice dysfunction index scale VHI-10, auditory perception evaluation scale GRBAS and voice analysis software were used to evaluate the voice function of patients subjectively and objectively at 1 day before operation, 1 week and 3 months after surgery. ResultsThe operative time was (128.13±48.36) min, the amount of blood loss was (16.36±8.23) mL. There were no significant differences in the points of function, physiology and emotion evaluated by VHI-10 scale at 1 week and 3 months after operation compared with those before operation (P>0.05). There were no significant differences in the three characteristics points of voice roughness, breathiness, and strain evaluated by GRBAS scale at 1 week and 3 months after operation (P>0.05). At 1 week after operation, the total hoarseness grade and asthenia evaluated by GRBAS scale were increased in different degrees as compared with those before operation and the difference was statistically significant (P<0.05), while the total hoarseness grade and asthenia points were decreased at 3 months after operation and there was no significant difference as compared with that before operation (P>0.05). Voice acoustic analysis results showed that there were no significant differences in fundamental frequency, jitter, shimmer and harmonic to noise ratio of the patients between at 1 week or 3 months after operation and before operation (P>0.05). The maximum phonation time (MPT) of patients was decreased at 1 week after operation as compared with that before operation, and the difference was statistically significant (P<0.05). The MPT of the patients recovered at 3 months after operation, and there was no significant difference as compared with that before operation (P>0.05). The dysphonia severity index (DSI) of patients at 1 week after surgery was decreased as compared with that before surgery, and the difference was statistically significant (P<0.05). The DSI was increased at 3 months after operation and there was no significant difference as compared with that before operation (P>0.05). ConclusionRobot radical thyroidectomy via axillary breast is safe and can protect the voice function.
ObjectiveTo investigate the safety and feasibility of domestic MP1000 robotic surgical system assisted thyroidectomy via submaxillary approach in porcine animal model. MethodThe thyroidectomy process assisted by the MP1000 robotic surgical system via submaxillary approach for a Bama pig in the 960th Hospital of the Joint Logistics Support Force was retrospectively analyzed. ResultsThe operation was performed as planned programme using the MP1000 robotic surgical system without opening, adding or lengthening the surgical incision. There was no mechanical problems during the MP1000 robotic surgical operation. The operative time was 53 min and the estimated intraoperative blood loss was 10 mL. There was no shaking of instruments and robotic arm during the operation, and the 3 surgical instruments cooperated skillfully, the establishment of surgical operation space successfully was completed, the thyroid blood vessels accurately and finely was dissected, and the separation, coagulation and cutting of blood vessels were smoothly completed. The recurrent laryngeal nerve and parathyroid gland were delicately dissected and protected. The carotid sheath, trachea, esophagus, and other important organs around the thyroid did not be damaged. The master-slave mapping frequency was high, and there was no delay sense during the operation. The lens resolution of MP1000 was 1 920×1 080, the surgical field of vision was clear, no visual field was defected and the visual field was stable and not shaking, light source front and intelligent adaptive temperature control system reduced the fogging of the lens, and the lens was scoured for 4 times during the operation. ConclusionAccording to the preliminary results of the experimental animal in this study, MP1000 robotic surgical system can successfully complete thyroidectomy via submaxillary approach in porcine animal model.