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Initial experience with robot-assisted modified radical neck dissection for the management of thyroid carcinoma with lateral neck node metastasis

Authors
 Sang-Wook Kang  ;  So Hee Lee  ;  Haeng Rang Ryu  ;  Kang Young Lee  ;  Jong Ju Jeong  ;  Kee-Hyun Nam  ;  Woong Youn Chung  ;  Cheong Soo Park 
Citation
 SURGERY, Vol.148(6) : 1214-1221, 2010 
Journal Title
SURGERY
ISSN
 0039-6060 
Issue Date
2010
MeSH
Adult ; Axilla/pathology ; Female ; Functional Laterality ; Humans ; Length of Stay ; Lymph Node Excision/methods* ; Lymph Nodes/pathology* ; Lymph Nodes/surgery ; Male ; Middle Aged ; Neck/surgery ; Neoplasm Staging ; Robotics/methods* ; Surgical Flaps/pathology ; Surgical Instruments ; Thyroid Gland/anatomy & histology ; Thyroid Neoplasms/pathology ; Thyroid Neoplasms/surgery* ; Treatment Outcome ; Young Adult
Abstract
BACKGROUND: Since the introduction of endoscopic techniques in thyroid surgery, several trials of endoscopic lateral neck dissection have been conducted with the aim of avoiding a long cervical scar, but these endoscopic procedures require more effort than open surgery, mainly because of the relatively nonsophisticated instruments used. However, the recent introduction of surgical robotic systems has simplified the operations and increased the precision of endoscopic techniques. We have described our initial experience with robot-assisted modified radical neck dissection (MRND) in thyroid cancer using the da Vinci S system. METHODS: From October 2007 to October 2009, 33 patients with thyroid cancer with lateral neck lymph node (LN) metastases underwent robot-assisted thyroidectomy and additional robotic MRND using a gasless, transaxillary approach. Clinicopathologic data were analyzed retrospectively. RESULTS: Mean patient age was 37 ± 9 years and the gender ratio (male to female) was 7:26. The mean operating time was 281 ± 41 minutes and mean postoperative hospital stay was 5.4 ± 1.6 days. The mean tumor size was 1.1 ± 0.5 cm and 20 cases (61%) had papillary thyroid microcarcinoma. The mean number of retrieved LNs was 6.1 ± 4.4 in the central neck compartment and 27.7 ± 11.0 in the lateral compartment. No serious postoperative complications, such as Horner's syndrome or major nerve injury, occurred. CONCLUSION: Robot-assisted MRND is technically feasible, safe, and produces excellent cosmetic results. Based on our initial experience, robot-assisted MRND should be viewed as an acceptable alternative method in patients with low-risk, well-differentiated thyroid cancer with lateral neck node metastasis.
Full Text
http://www.sciencedirect.com/science/article/pii/S0039606010005088
DOI
10.1016/j.surg.2010.09.016
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Sang Wook(강상욱) ORCID logo https://orcid.org/0000-0001-5355-833X
Nam, Kee Hyun(남기현) ORCID logo https://orcid.org/0000-0002-6852-1190
Park, Cheong Soo(박정수)
Ryu, Haeng Rang(유행랑)
Lee, So Hee(이소희)
Chung, Woong Youn(정웅윤)
Jeong, Jong Ju(정종주) ORCID logo https://orcid.org/0000-0002-4155-6035
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/102980
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