Robotic Thyroidectomy

Robotic Thyroidectomy is a relatively recent development in the field of thyroid surgery. This technique involves removal of a part or whole of the thyroid gland via retroauricular or transaxillary approach using Da Vinci Robotic system. The daVinci system has:

Four robotic hands: These are called EndoWrist instruments, and they do work just like hands. They can grab things, twist, and turn—and they’re incredibly small. The robotic hands allow the surgeon to make very precise movements.

3D camera: This is a high-definition camera that gives the surgeon a 3D image of the thyroid. He or she can zoom in and get an even more detailed look; the camera includes magnification of 10x.

Console: The surgeon sits at the console, where he or she controls the four robotic hands and sees images from the 3D camera.

The robotic hands and the 3D camera are inserted through the incisions. The surgeon can then accurately remove part or all of the thyroid, depending on what the patient needs.This does not mean that robot will be doing the surgery. The daVinci robot is completely under the control of the surgeon. The robotic hands cannot move on their own; they must be told what to do by the surgeon. This surgery avoids a scar in the neck, as approach is made either from behind the ear (Retroauricular) or from the armpit (Transaxillary). Before its development, there were two main options for thyroid surgery: conventional open surgery or endoscopic surgery. Conventional open surgery involves a scar on the neck; endoscopic techniques might or might not involve a neck scar. Open thyroid surgery, also known as standard or conventional open surgery, uses a 4-6cm long incision for most patients. For many years, it was the only thyroidectomy technique available. The surgeon would expose the entire thyroid so that he or she could directly see the gland and what to remove. Open surgery led to endoscopic surgery, which is a minimally invasive technique. The surgeon uses a small camera to see what he or she is working on while they do the surgery with special instruments. Robotic thyroidectomy has following advantages in comparison to open surgery:

• The biggest benefit is, of course, the lack of a scar on the neck.
• Better view: With open surgery, you’re looking at the thyroid from the top down, so it’s a little difficult to see the deeper structures, such as the recurrent laryngeal nerve. The 3D camera gives you a magnified view in robotic thyroidectomy and enables you look at the thyroid directly.”
• Better identification of critical structures: Due to the magnified 3D view, it is easier to identify critical structures, such as the recurrent laryngeal nerve (the nerve that goes to your voice box) and parathyroid glands.
• Better dexterity in certain areas: The robotic instruments give the surgeon a 6º freedom of motion, which enables manipulation of certain portions of the thyroid more easily.

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