TY - JOUR
T1 - Robotic facelift thyroidectomy
T2 - Patient selection and technical considerations
AU - Terris, David J.
AU - Singer, Michael C.
AU - Seybt, Melanie W.
PY - 2011/8
Y1 - 2011/8
N2 - Objectives: A series of remote access thyroidectomy techniques, some using a surgical robot, have been introduced in the last decade. Most of these approaches require awkward positioning, use unfamiliar dissection planes, and have been associated with a number of significant complications. As a result, acceptance has been limited. We describe technical details and patient selection criteria of a recently described robotic facelift thyroidectomy (RFT) approach that avoids these pitfalls. DESIGN: Analysis of preclinical and clinical studies. Methods: Inanimate and cadaver dissection studies and clinical implementation were pursued. A 3-arm RFT technique with a 30-degree offset base location proved optimal. Supine positioning with arms tucked and the patient in slight Trendelenburg position facilitated the dissection of the optical pocket. Demographic and surgical data that have been obtained and considered include patient age, sex, body mass index, pathology, and complications. Results: A series of consecutive RFT procedures has been accomplished in a limited population of patients. All cases were completed robotically with no conversions to open surgery necessary. All but the first case was accomplished on a drainless, outpatient basis. Conclusions: A RFT technique that is gasless and uses a single access port in the postauricular crease and occipital hairline location is feasible, technically less challenging than other remote access methods, and safe. Further study in an expanded patient population and in additional high-volume thyroid centers is warranted. See the videos, Supplemental Digital Content 1, http://links.lww.com/SLE/ A36andSupplementalDigitalContent2, http://links.lww.com/SLE/A37.
AB - Objectives: A series of remote access thyroidectomy techniques, some using a surgical robot, have been introduced in the last decade. Most of these approaches require awkward positioning, use unfamiliar dissection planes, and have been associated with a number of significant complications. As a result, acceptance has been limited. We describe technical details and patient selection criteria of a recently described robotic facelift thyroidectomy (RFT) approach that avoids these pitfalls. DESIGN: Analysis of preclinical and clinical studies. Methods: Inanimate and cadaver dissection studies and clinical implementation were pursued. A 3-arm RFT technique with a 30-degree offset base location proved optimal. Supine positioning with arms tucked and the patient in slight Trendelenburg position facilitated the dissection of the optical pocket. Demographic and surgical data that have been obtained and considered include patient age, sex, body mass index, pathology, and complications. Results: A series of consecutive RFT procedures has been accomplished in a limited population of patients. All cases were completed robotically with no conversions to open surgery necessary. All but the first case was accomplished on a drainless, outpatient basis. Conclusions: A RFT technique that is gasless and uses a single access port in the postauricular crease and occipital hairline location is feasible, technically less challenging than other remote access methods, and safe. Further study in an expanded patient population and in additional high-volume thyroid centers is warranted. See the videos, Supplemental Digital Content 1, http://links.lww.com/SLE/ A36andSupplementalDigitalContent2, http://links.lww.com/SLE/A37.
KW - cosmetic
KW - endoscopic
KW - minimally invasive
KW - outpatient
KW - robotic
KW - thyroidectomy
UR - http://www.scopus.com/inward/record.url?scp=80052219725&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80052219725&partnerID=8YFLogxK
U2 - 10.1097/SLE.0b013e3182266dd6
DO - 10.1097/SLE.0b013e3182266dd6
M3 - Article
C2 - 21857471
AN - SCOPUS:80052219725
SN - 1530-4515
VL - 21
SP - 237
EP - 242
JO - Surgical Laparoscopy, Endoscopy and Percutaneous Techniques
JF - Surgical Laparoscopy, Endoscopy and Percutaneous Techniques
IS - 4
ER -