Single-Port Transaxillary Robotic Thyroidectomy (START) for Benign Thyroid Tumors

Abstract

Purpose Single-port transaxillary robotic thyroidectomy using the da Vinci SP® system with a two-step retraction method is known to be a practical surgical method that maximizes the cosmetic and functional benefits for patients and reduces the workload fatigue of surgeons by increasing robotic dependency. This study aimed to evaluate its technical feasibility in the treatment of benign tumors.

Methods We retrospectively analyzed the data of patients who were diagnosed with benign thyroid disease after undergoing single-port transaxillary robotic thyroidectomy with a two-step retraction method using the da Vinci SP® robotic system at Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, between May 2019 and May 2022. Patients with Graves’ disease were excluded from this study.

Results Twenty-two patients were enrolled in this study, 21 females and one male, with a mean age of 32.7 years (range: 17–52 years). The mean body mass index was 22.5±3.1 kg/m2 (range: 18.0–29.7 kg/m2). The mean tumor size was 2.8±1.5 cm (range, 0.4–5.9 cm), and the mean operation time was 173.4±26.8 min (range, 128–226 min). There were no intraoperative complications. The mean estimated blood loss was 3.2±7.6 mL (range, 0–30 mL). No serious postoperative complications occurred, except one case of seroma.

Conclusion Single-port transaxillary robotic thyroidectomy’s utilization of a narrow working space is useful for benign thyroid tumors. It is feasible and safe for experienced robotic surgeons treating benign thyroid tumors.