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Yonsei Experience of 5000 Gasless Transaxillary Robotic Thyroidectomies

 Min Jhi Kim  ;  Kee-Hyun Nam  ;  Seul Gi Lee  ;  Jung Bum Choi  ;  Tae Hyung Kim  ;  Cho Rok Lee  ;  Jandee Lee  ;  Sang-Wook Kang  ;  Jong Ju Jeong  ;  Woong Youn Chung 
 World Journal of Surgery, Vol.42(2) : 393-401, 2018 
Journal Title
 World Journal of Surgery 
Issue Date
Adenocarcinoma, Papillary/surgery ; Adenoma/surgery ; Adult ; Female ; Graves Disease/surgery ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Operative Time ; Postoperative Complications/etiology ; Retrospective Studies ; Robotic Surgical Procedures*/adverse effects ; Thyroid Diseases/surgery* ; Thyroid Neoplasms/surgery* ; Thyroidectomy/adverse effects ; Thyroidectomy/methods*
BACKGROUND: Since the use of robot systems in thyroid surgery was introduced in 2007, we have advanced a novel method of robotic thyroidectomy (RT) using a gasless transaxillary approach (TAA). We report our experience with this technique and detail the surgical outcome of 5000 robotic thyroidectomies. METHODS: From October 2007 to May 2016, we successfully performed 5000 robotic thyroidectomies using a gasless TAA at the Department of Surgery, Yonsei University Health System. The medical records of the patients are reviewed retrospectively, and the details of clinicopathologic characteristics, operation times, perioperative complications, and oncologic outcomes are analyzed. RESULTS: The 5000 patients with thyroid tumor (4804 with cancer and 196 with benign tumor) underwent RT using a gasless TAA. Mean operation time was 134.5 ± 122.0 min. The most common histologic subtype of thyroid cancer was papillary (98%), and the mean tumor size was 8.0 ± 6.0 mm. Stage I was found in 85.4% patients regarding tumor nodes metastasis staging. The 196 benign tumors consisted of 104 adenomatous hyperplasias (53.0%), 43 follicular adenomas (21.9%), 30 Graves' diseases (15.3%), and 19 others (9.7%). Postoperative complication occurred in 24.1% without any serious one, and overall morbidity tended to decrease over time. No disease-specific mortality was observed during the follow-up period. Locoregional recurrence was developed in 26 patients (0.5%). CONCLUSION: The authors have tried to improve RT technique using gasless TAA and achieved acceptable surgical outcomes. The rapid evolution of surgical robot technology and our constant effort to advance RT technique using gasless TAA would make it possible to reduce the perioperative morbidity and gain the best possible operative and oncologic outcomes.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
강상욱(Kang, Sang Wook) ORCID logo https://orcid.org/0000-0001-5355-833X
김민지(Kim, Min Jhi)
김태형(Kim, Tae Hyung)
남기현(Nam, Kee Hyun) ORCID logo https://orcid.org/0000-0002-6852-1190
이슬기(Lee, Seul Gi) ORCID logo https://orcid.org/0000-0003-3233-7823
이슬기(Lee, Seul Gi)
이잔디(Lee, Jan Dee) ORCID logo https://orcid.org/0000-0003-4090-0049
이초록(Lee, Cho Rok) ORCID logo https://orcid.org/0000-0001-7848-3709
정웅윤(Chung, Woung Youn)
정종주(Jeong, Jong Ju) ORCID logo https://orcid.org/0000-0002-4155-6035
최정범(Choi, Jung Bum)
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