Robotic and Extracervical Approaches to the Thyroid and Parathyroid Glands

Multiple extracervical approaches to thyroidectomy and parathyroidectomy were developed with robotic-assisted technology; in the United States, transaxillary and retroauricular or “facelift” approaches are the most common. These conventional robotic-assisted extracervical approaches may be considered for appropriately selected patients, including those with a history of keloids or hypertrophic scars. Reports of successful, safe application of robotic-assisted thyroidectomy for multiple pathologies, including thyroid cancer, have been reported with increasing case numbers in the literature. Robotic-assisted technology allowed surgeons to overcome limitations of the endoscopic approach to thyroidectomy, with three-dimensional visualization and multiarticulated arms ideal for the limited workspace available in the neck. multiple robotic-assisted extracervical approaches to thyroidectomy were developed as a result. Transaxillary and retroauricular or “facelift” thyroidectomy are the most commonly performed remote-access procedures in the United States, and with the recent introduction of transoral thyroidectomy, they may be considered “conventional” robotic approaches. Transoral thyroidectomy is safe and feasible. However, some pending questions about this procedure still remain, which include learning curve, long-term outcomes that should be demonstrated and further studied.