1
|
Nayak SP, Sadhoo A, Gangadhara B, Reddy S, Khan A, Munisiddaiah D, Ramakrishnan A. Robotic-assisted breast-axillo insufflation thyroidectomy (RABIT): a retrospective case series of thyroid carcinoma. Int J Clin Oncol 2019; 25:439-445. [PMID: 31667663 DOI: 10.1007/s10147-019-01568-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 10/22/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To evaluate the feasibility and safety of robotic-assisted breast-axillo insufflation thyroidectomy (RABIT) for differentiated thyroid cancer. METHODS In this retrospective case series, patients with differentiated thyroid carcinoma were enrolled in our hospital from January 2018 to December 2018. All patients underwent indirect laryngoscopy to assess the status of vocal cord preoperatively. RABIT was performed with five separate breast-axillo incisions. All the procedures were performed using da Vinci Xi Robotic Surgical System, a single docking method using CO2 insufflation. RESULTS Twelve patients completed RABIT, in which one case needed conversion to open thyroidectomy. The mean age was 30.25 ± 7 with male to female ratio being 1:1. Preoperative diagnosis showed papillary carcinoma (n = 9) and follicular neoplasm (n = 3). The mean operative time for RABIT was 140 ± 50.45 min and average blood loss during surgery was 22.92 ± 9 mL. Mean hospital stay was 4.42 ± 1.08 days. Final pathology confirmed classical papillary thyroid carcinoma (n = 10; 83.3%) and follicular variant of papillary carcinoma (n = 2; 16.7%). None of the cases reported injury or paralysis to the recurrent laryngeal nerves. CONCLUSION RABIT is a safe and feasible approach for thyroidectomy. It has several advantages in that it provides similar symmetrical view to conventional open surgery and enables to maintain specimen integrity and use of assistant port permits better handling of the gland. Additionally, the largest operating angles with this technique prevent collision between the robotic arms and provide excellent cosmetic satisfaction due to very small, five separate breast-axillo incisions.
Collapse
Affiliation(s)
- Sandeep P Nayak
- Department of Surgical Oncology, Fortis Hospitals, 154, 9, Bannerghatta Main Rd, Opposite IIM, Sahyadri Layout, Panduranga Nagar, Bangalore, Karnataka, 560076, India.
| | - Abhilasha Sadhoo
- Department of Surgical Oncology, Fortis Hospitals, 154, 9, Bannerghatta Main Rd, Opposite IIM, Sahyadri Layout, Panduranga Nagar, Bangalore, Karnataka, 560076, India
| | - Bharath Gangadhara
- Department of Surgical Oncology, Fortis Hospitals, 154, 9, Bannerghatta Main Rd, Opposite IIM, Sahyadri Layout, Panduranga Nagar, Bangalore, Karnataka, 560076, India
| | - Sreekanth Reddy
- Department of Surgical Oncology, Fortis Hospitals, 154, 9, Bannerghatta Main Rd, Opposite IIM, Sahyadri Layout, Panduranga Nagar, Bangalore, Karnataka, 560076, India
| | - Ameenuddin Khan
- Department of Surgical Oncology, Fortis Hospitals, 154, 9, Bannerghatta Main Rd, Opposite IIM, Sahyadri Layout, Panduranga Nagar, Bangalore, Karnataka, 560076, India
| | - Devaprasad Munisiddaiah
- Department of Surgical Oncology, Fortis Hospitals, 154, 9, Bannerghatta Main Rd, Opposite IIM, Sahyadri Layout, Panduranga Nagar, Bangalore, Karnataka, 560076, India
| | - Athira Ramakrishnan
- Department of ENT, Fortis Hospitals, Bannerghatta Main Rd, Bangalore, 560076, India
| |
Collapse
|
2
|
Microscopic Thyroidectomy: A Prudent Option. Indian J Otolaryngol Head Neck Surg 2019; 71:212-217. [PMID: 31275833 DOI: 10.1007/s12070-018-1551-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 12/04/2018] [Indexed: 10/27/2022] Open
Abstract
Microscopic Thyroidectomy is not a new surgical technique but it is not explored much. The routine use of microscope in thyroid surgery can reduce the rate of nerve palsy and hypocalcemia. Nine cases were done exclusively with the microscope only and postoperative nerve palsy and hypocalcemia were noted. We have also discussed about optimum working distances and magnification for critical structures during thyroid surgery. No patient has any nerve palsy while one patient reported transient hypocalcemia. Recurrent laryngeal nerve could be identified at 2 × but optimal magnification for dissection of nerve should be 4 ×. We find this technique easy to adopt and critical structures can be identified and preserved easily with microscopic thyroidectomy then conventional and loupe technique. It is better to have standardized and optimum working distance and magnification during different steps of surgery. It is great teaching tool in view of its better illumination and magnification.
Collapse
|
3
|
Mayilvaganan S, Bothra S. Robot Assisted Trans Axillary Thyroidectomy: A Subcontinent Experience. Indian J Otolaryngol Head Neck Surg 2018; 70:607. [PMID: 30464925 DOI: 10.1007/s12070-018-1416-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 05/28/2018] [Indexed: 11/29/2022] Open
Affiliation(s)
- Sabaretnam Mayilvaganan
- Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014 India
| | - Sapana Bothra
- Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014 India
| |
Collapse
|